沙美特罗替卡松粉吸入剂对慢性阻塞性肺疾病肺气肿患者血清中性粒细胞弹性蛋白酶、α1-抗胰蛋白酶的影响  

Effect of inhaled seretide in serum neutrophil elastase and α1-antitrypsin of chronic obstructive pulmonary disease patients with emphysema

作　　者：孙金林[1] 陈旭东[1] 

机构地区：[1]山东省交通医院呼吸内科,济南250000

出　　处：《国际医药卫生导报》2014年第2期193-196,共4页International Medicine and Health Guidance News

摘　　要：目的 探讨吸入舒利迭（沙美特罗替卡松粉吸入剂）对COPD（慢性阻塞性肺疾病）肺气肿患者血清NE、α 1-AT的影响,为临床COPD肺气肿治疗提供依据.方法 选择COPD肺气肿患者142例,按照COPD严重程度进行分型,轻度75例,中度42例,重度25例,所有患者均采用舒利迭治疗,另选30例健康体检者作对照组,观察三组患者治疗前后血清NE、α 1-AT的变化情况,并与对照组比较;观察患者肺气肿、肺功能恢复情况.结果 治疗前不同严重程度患者的α1-AT较健康对照组明显降低（P＜0.05）,病情越严重,α1-AT水平越低（P＜0.05）,而NE水平则较健康对照组明显增高,随病情严重度增加而增加（P＜0.05）;治疗后轻度COPD患者α1-AT明显增,NE则明显下降（P＜0.05）;中度、重度COPD患者α1-AT及NE改善不明显或无改善（P＞0.05）;轻度组患者肺气肿恢复率、肺功能改善明显高于中、重度患者（P＜ 0.05）.结论 舒利迭治疗COPD肺气肿,对病情较轻的患者可有效改善NE、α1-AT水平,使蛋白酶/抗蛋白酶趋于平衡,但对于中度、重度的患者的效果甚微.Objective To investigate the effect of inhaled seretide in serum NE, α 1-AT of COPD patients with emphysema, in order to provide basis for clinically treating emphysema. Methods 142 COPD patients with emphysema were selected and parted according to severity of COPD （75 mild cases, 42 moderate cases and 25 severe cases）, who were all treated with seretide. 30 healthy people were selected as control group. Serum NE, α 1-AT levels of three groups of patients before and after treatment and control group, emphysema and lung function recovery of patients were observed. Results Before treatment,α1-AT level of patients was lower than that of control group（P 〈 0.05）; the more serious illness was, the lower α 1-AT level was （P 〈 0.05）. NE level of patients was significantly higher than that of control group; the more serious illness was, the higher NE level was （P 〈 0.05）. After treatment, α1-AT level of mild patients significantly increased, but NE level significantly decreased （P 〈 0.05）; α1-AT levels of moderate and severe patients didn＇ t significantly change （P 〉 0.05）. The emphysema recovery rate and lung function of mild patients improved more than those of moderate and severe patients （P 〈 0.05）. Conclusions Inhaled seretide in the treatment of COPD with emphysema can effectively improve NE and α 1-AT level of mild patients, make protease/antiprotease balanced, but has little effect on moderate and severe patients.

关 键 词：舒利迭 慢性阻塞性肺疾病 肺气肿 中性粒细胞弹性蛋白酶 Α1-抗胰蛋白酶 

分 类 号：R563.9[医药卫生—呼吸系统]