噻托溴铵和沙美特罗替卡松在COPD稳定期患者的应用及对深吸气量的影响  

Application of Tiotropium Bromide and Salmeterol/Fluticasone Propionate for COPD patients in stable phase and the effect on inspiratory capacity

作　　者：张威[1] 高赏[1] 任魁[1] 聂秀红[1] 肖汉[1] 

机构地区：[1]首都医科大学宣武医院呼吸内科,北京100053

出　　处：《国际呼吸杂志》2016年第12期898-901,共4页International Journal of Respiration

摘　　要：目的：分析噻托溴铵（思力华）与沙美特罗替卡松（舒利迭）在 COPD稳定期患者中的应用价值。方法选取我科收治的90例COPD稳定期患者作为研究对象,随机分为 A、B、C 3组,各30例,分别采用沙美特罗替卡松、噻托溴铵及沙美特罗替卡松联合噻托溴铵吸入治疗,测定3组治疗前、治疗3个月后肺部深吸气量（inspiratory capacity,IC）、功能残气量（functional residual capacity,FRC）、FEV1、FVC、FEV1/FVC变化情况,同时监测3组治疗前后PaO2、PaCO2的变化,并采用COPD患者自我评估测试（COPD assessment test,CAT）问卷表评估患者治疗前后生活质量的改善情况。结果 A组总有效率60.00%,B组总有效率66.67%,C组总有效率90.00%,C 组有效率高于 A、B 2组（P值均〈0.05）；治疗3个月后,3组IC、FRC均有改善,其中C组IC上升幅度、FRC降低幅度均明显高于 A、B 2组,对比差异有统计学意义（P值均〈0.05）；治疗3个月后,3组FVC、FEV1、FEV1/FVC均有所改善,以C组改善最明显,与 A、B 2组对比差异有统计学意义（P值均〈0.05）；治疗后,C组PaCO2、CAT评分降低幅度高于 A、B 2组,PaO2上升幅度高于 A、B 2组,对比差异有统计学意义（P 值均〈0.05）；且3组治疗不良反应对比差异无统计学意义（P 〉0.05）。结论采用噻托溴铵联合沙美特罗替卡松治疗 COPD 稳定期患者,可改善肺功能、提高 IC,同时改善患者的血气指标,从而提升患者生活质量,安全可靠。Objective To analyze the application value of Tiotropium Bromide （Spiriva） and Salmeterol/Fluticasone Propionate （Seretide） in patients with chronic obstructive pulmonary disease （COPD） in stable phase.Methods Ninety cases of patients with COPD in stable phase treated in our hospital were selected as the study object and were randomly divided into A,B,C groups,with 30 cases in each group.The three groups were respectively treated with Salmeterol/Fluticasone Propionate, Tiotropium Bromide and Salmeterol/Fluticasone Propionate combined with Tiotropium Bromide inhalation.The differences of inspiratory capacity （IC）,functional residual capacity （FRC）,forced expiratory volume in 1 second（FEV1）,forced vital capacity（FVC）and the forced expiratory volume in 1 second and forced vital capacity ratio （FEV1/FVC） in the three groups before and after 3 months of treatment were determined.The levels of arterial partial pressure of oxygen （PaO2） and arterial carbon dioxide partial pressure （PaCO2） blood gas indexes in the three groups were monitored.The COPD assessment test（CAT）questionnaires were used to evaluate the improvement of quality of life before and after treatment.Results The total effective rate in group A was 60.00% while in group B was 66.67%and in group C was 90.00%.The effective rate in group C was higher than those in group A and B（all P〈0.05）.After three months of treatment,IC and FRC in the three groups were improved,the differences of the increasing range of IC and the decreasing range of FRC in group C were significantly higher than those in group A and group B （all P 〈0.05）.After three months of treatment,FVC,FEV1 and FEV1/FVC were improved in three groups and the improvement in group C was the most significant（all P〈0.05）. After treatment,the decreasing ranges of PaCO2 and CAT scores in group C were higher than those in group A and group B while the increasing range of PaO2 was significantly higher than that in group A and group B（all P〈0.05

关 键 词：慢性阻塞性肺疾病 稳定期 噻托溴铵(思力华) 沙美特罗替卡松(舒利迭) 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]