异丙托溴铵对哮喘伴COPD患者支气管痉挛的治疗作用  

Therapeutic effect of ipratropium bromide on bronchial spasm in asthma and COPD

作　　者：盛芬[1] 黄茂[1] 张添威 SHENG FenA HUANG Mao ZHANG Tian-wei(Department of Respiration, Taizhou First Peopled Hospital, Taizhou 318020 , China)

机构地区：[1]台州市第一人民医院呼吸科,浙江台州318020

出　　处：《中国生化药物杂志》2016年第12期107-110,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨异丙托溴铵对哮喘伴慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者支气管痉挛的治疗作用。方法选取哮喘伴COPD患者174例,按随机数字表法分组,对照组87例予以布地奈德福莫特罗粉吸入剂治疗,研究组87例在对照组基础上予以异丙托溴铵治疗,检查记录2组间肺通气功能、气道阻力、诱导痰细胞因子水平,同时比较临床疗效及不良反应发生率。结果对照组治疗有效率(81.61%)低于研究组治疗有效率(93.11%)(P<0.05);与对照组比较,研究组治疗后呼气峰值流速(peak expiratory flow,PEF)、最大呼气中段流量(maximum midexpiratory flow,MMEF)、1 s用力呼气容积占预计值百分比(forced expiratory volume in one second to forced vital capacity ratio,FEV1%)及用力肺活量(forced vital capacity,FVC)水平较高,治疗后气道阻力(airway resistance,Raw)、气道阻力占预计值百分比(Raw%)水平较低,比气道传导率(specific airway conductance,Gsp)水平较高,治疗后诱导痰血管内皮生长因子(vascular endothelial growth factor,VEGF)、细胞间黏附分子(intercellular adhesion molecular-1,ICAM-1)、白细胞介素-13(interleukin-13,IL-13)、白细胞介素-17(IL-17)水平较低(P<0.05)。2组患者不良反应发生率差异无统计学意义。结论异丙托溴铵治疗哮喘伴COPD的临床疗效确切,能够明显改善患者肺通气功能,缓解支气管痉挛,降低气道阻力,抑制气道炎症反应,且安全性较高。Objective To investigate the therapeutic effect of ipratropium bromide on bronchial spasm of patients with asthma and chronic obstructive pulmonary disease（ COPD）. Methods 174 patients with asthma and COPD were selected and divided into two groups,87 cases in the control group treated with budesonide and formoterol fumarate powder for inhalation,87 cases in the experimental group received ipratropium bromide on the basis of the control group,pulmonary ventilation function,airway resistance and cytokine levels in induced sputum,the clinical effect and incidence of adverse reactions were compared after the treatment. Results The effective rate in the control group（ 81. 61%） was lower than the experimental group（ 93. 11%）,with significant difference（ P〈0. 05）; compared with the control group,levels of peak expiratory flow（ PEF）,maximum midexpiratory flow（ MMEF）,forced expiratory volume in one second to forced vital capacity ratio（ FEV1%）,forced vital capacity（ FVC） were higher in the experimental group after treatment,levels of airway resistance（ Raw）,Raw% were lower,level of specific airway conductance（ Gsp） was higher after treatment,induced sputum levels of vascular endothelial growth factor（ VEGF）,intercellular adhesion molecular-1（ ICAM-1）,interleukin-13（ IL-13）,IL-17 were lower after treatment,with significant difference（ P〈0. 05）; there was no significant difference in the incidence of adverse reactions between the two groups. Conclusion The clinical effect of ipratropium bromide in the treatment of asthma and COPD was exactly,ipratropium bromide can significantly improve the pulmonary ventilation function in patients,relieve bronchial spasm,reduce airway resistance,inhibit airway inflammation,and the safety is higher.

关 键 词：哮喘 慢性阻塞性肺疾病 异丙托溴铵 支气管痉挛 肺功能 临床疗效 

分 类 号：R562.2[医药卫生—呼吸系统]