肺功能分组在治疗慢性阻塞性肺疾病中的临床应用  

Therapeutic responses of subgroups classified by pulmonary function test in chronic obstructive pulmonary disease patients

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,河北沧州061000

出　　处：《中国现代医学杂志》2015年第31期53-57,共5页China Journal of Modern Medicine

摘　　要：目的比较根据肺功能指标(一氧化碳弥散量和深吸气量)分成不同组别的慢性阻塞性肺疾病(COPD)患者对茶碱联合沙美特罗氟替卡松50μg/250μg治疗反应是否存在差别。方法选取2012年7月-2014年7月在该院就诊的稳定期中重度慢阻肺患者104例,依据一氧化碳弥散量(DLCO)和深吸气量(IC)分成4组。DLCO及IC均正常组(A组)9例,DLCO减低IC正常组(B组)18例,DLCO正常IC减低组(C组)22例,DLCO及IC均减低组(D组)55例。4组均给予茶碱缓释片(0.1 g,口服2次/d)联合吸入沙美特罗氟替卡松(50μg/250μg,吸入2次/d)治疗3个月,比较4组患者的肺功能指标及慢性阻塞性肺病评估测试问卷(CAT)评分的变化。结果各组治疗3个月后FEV1、FVC和CAT评分的变化差异具有统计学意义(P<0.05)。其中FEV1的增加以C组最明显,而D组较之B组明显。C组较之B组和D组FVC的增加更明显,且C组CAT评分的改善大于B组和D组(P<0.05)。结论根据肺功能指标(DLCO、IC)将COPD患者分组,有助于预测患者的药物治疗反应。[ Objective ] To compare therapeutic responses in chronic obstructive pulmonary disease （COPD） subgroups, classified by diffusing capacity of the lung for carbon monoxide （DLCO） and inspiratory capacity （IC）. [Methods] 104 mid-severe range COPD patients in stable period were recruited in Cangzhou Central Hospital from July 2012 to July 2014. According to baseline DLCO and IC, the patients were divided into normal DLCOflC group （group A, n = 9）, low DLCO/normal IC group （group B, n = 18）, normal DLCO/low IC group （group C, n = 22） and low DLCOflC group （group D, n = 55）. We compared therapeutic responses to 3-month treatment of theophylline （0.1 g, po, bid） plus Salmeterol Fluticasone （50 μg/250 μg, inhale, bid） among the four groups. [ Results ] Group C showed the greatest FEV1 increase. Group D showed a greater FEV1 increase than group B. Group C showed a greater FVC increase and CAT decrease than group B and group D （P 〈 0.05）. [Conclusion] COPD subgroups classified by DLCO and IC may be helpful to predict responses to pharmacologic treatment.

关 键 词：肺疾病 慢性阻塞性 弥散功能 深吸气量 茶碱 沙美特罗 氟替卡松 

分 类 号：R562.12[医药卫生—呼吸系统]