基于一氧化碳弥散量与深吸气量分组的COPD患者对吸入布地奈德福莫特罗的反应比较  

Comparison of the Therapeutic Responses of COPD Patients to Budesonide / formoterol Based on Grouping by DLCO and IC

作　　者：王晓晟[1] 施健[1] 吕静[1] 周丽荣[1] 康筱玲[1] 孙宝华[1] 

机构地区：[1]河北省沧州市中心医院呼吸内一科,061000

出　　处：《中国全科医学》2015年第23期2766-2770,共5页Chinese General Practice

摘　　要：目的比较不同一氧化碳弥散量(DLCO)和深吸气量(IC)的COPD患者对吸入布地奈德福莫特罗治疗的反应。方法选取2012年6月—2014年6月于沧州市中心医院就诊的稳定期中重度COPD患者105例为研究对象,患者经过2周的清洗期,均给予3个月的布地奈德福莫特罗320μg/9μg治疗。根据治疗前DLCO占预计值百分比和IC占预计值百分比,将患者分为DLCO及IC均正常组(A组,10例)、DLCO减低且IC正常组(B组,18例)、DLCO正常且IC减低组(C组,22例)、DLCO及IC均减低组(D组,55例)。收集患者临床特征资料,采用胸部高分辨率CT进行肺气肿视觉评分。比较各组治疗前后第1秒用力呼气末容积(FEV1)、用力肺活量(FVC)及COPD评估测试(CAT)评分的变化。结果各组男性比例、年龄、吸烟指数、CAT评分、急性加重次数、FVC、FEV1占预计值百分比、FVC占预计值百分比和肺气肿视觉评分比较,差异有统计学意义(P<0.05),其中,D组CAT评分高于其他各组;D组急性加重次数多于A组;C组FVC高于其他各组,D组FVC占预计值百分比低于其他各组;D组FEV1占预计值百分比低于A组和B组;B组和D组肺气肿视觉评分高于A组和C组(P<0.05)。各组治疗3个月后FEV1、FVC及CAT评分的变化比较,差异均有统计学意义(P<0.05);其中,C组FEV1变化的绝对值和相对值高于其他各组,D组FEV1变化的相对值高于B组;C组FVC变化的绝对值高于其他各组,FVC变化的相对值高于B组和D组;C组CAT评分变化大于B组和D组(P<0.05)。A组和C组出现咽部不适、声音嘶哑各1例,D组出现口腔真菌感染1例,经治疗后均好转。结论可依据DLCO联合IC对COPD进行分型,DLCO正常且IC减低的患者对布地奈德福莫特罗的治疗反应较好。Objective To compare the therapeutic responses to budesonide /formoterol among patients with different DLCO and IC.Methods We enrolled 105 mid -severe range COPD patients in stable period who received treatment in Cangzhou Central Hospital from June 2012 to June 2014.After two weeks′washing period , the subjects were all administrated with budesonide/formoterol （320 μg/9 μg） for three months.According to DLCO and IC before treatment , the subjects were divided into normal DLCO/IC group （group A, n=10）, low DLCO /normal IC group （group B, n=18）, normal DLCO/low IC group （group C, n=22） and low DLCO/low IC group （group D, n=55）.We collected the clinical data of the patients and used chest HRCT to conduct visual scoring of emphysema .Before and after treatment , comparison was made among the four groups in FEV1, FVC and CAT score.Results The four groups were significantly different （P〈0.05） in male ratio, age, smoking index, CAT score, the times of exacerbation, FVC, the ratio of FEV1 in predictive value, the ratio of FVC in predictive value and visual score of emphysema; group D was higer （ P〈0.05 ） than other groups in CAT score; group D was higher （P〈0.05） than group A in the times of exacerbation; group C was higher （P〈0.05） than other groups in FVC, and＆amp;nbsp;group D was lower （ P〈0.05 ） than other groups in the ratio of FVC in the predictive value; group D was lower （ P〈0.05 ） than group A and group B in the ratio of FEV1 in the predictive value; group B and group D were higher （P〈0.05） than group A and group C in the visual score of emphysema .Three months after treatment , the four groups were significantly different （ P〈0.05） in FEV1, FVC and CAT score; group C was higher （P〈0.05） than other groups in the absolute value and relative value of FEV1 change, and group D was higher （ P〈0.05） than group B in the relative value of FEV 1 change; group C was higher （ P〈0.05） than other groups in the absolute value of FVC c

关 键 词：肺疾病  慢性阻塞性 呼吸功能试验 一氧化碳弥散量 深吸气量 布地奈德福莫特罗 

分 类 号：R563.9[医药卫生—呼吸系统]