噻托溴铵辅治老年慢性阻塞性肺疾病疗效及对肺功能、TNF-α、IL-6的影响  

Clinical results and changes in lung function,TNF-a,IL-6 of elderly patients with chronic obstructive pulmonary disease in treatment with tiotropium bromide

作　　者：郑国峰[1] 李慧[1] 魏娇娜 张军[1] 

机构地区：[1]中国医科大学附属第四医院二呼吸内科,沈阳110005

出　　处：《疑难病杂志》2017年第3期230-233,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察噻托溴铵对老年慢性阻塞性肺疾病治疗效果及对肺功能、TNF-α、IL-6的影响。方法选择2015年3月—2016年3月中国医科大学附属第四医院二呼吸内科收治老年慢性阻塞性肺疾病患者96例为研究对象,随机分为观察组48例和对照组48例,对照组给予抗感染、祛痰、氧疗、口服长效氨茶碱片、沐舒坦扩张支气管等常规治疗;观察组在对照组基础上联合应用噻托溴铵吸入粉雾剂,18μg/次,1次/d,2组患者疗程均为8周;比较2组患者临床效果、肺功能[第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、第1秒用力呼气容积占用肺活量比值(FEV_1%)]及TNF-α、IL-6水平变化情况。结果治疗后观察组总有效率为89.6%,高于对照组的72.9%(x^2=4.376,P=0.036);治疗8周后,观察组FEV_1、FVC、FEV_1%、PaO_2、IL-10水平显著提高,PaCO_2、TNF-α、IL-6明显降低,与对照组比较差异亦有统计学意义(t=3.148、6.012、5.994、17.414、4.381、7.447、5.507、1.821,P<0.05)。结论噻托溴铵治疗慢性阻塞性肺疾病老年患者临床效果确切,能改善患者肺功能,减轻炎性反应状态,安全可靠,值得临床推广应用。Objective To investigate the clinical results and changes in lung function,TNF-a,IL-6 of elderly patients with chronic obstructive pulmonary disease in treatment with tiotropium bromide.Methods Ninety-six cases of elderly patients with chronic obstructive pulmonary disease were selected,which were treated in hospital from March 2015 to March2016,and they were divided into the study group（48 cases） and control group（48 cases）.The patients of control group were treated with routine treatment,including anti-infective,expectorant,oxygen therapy,oral long acting aminophylline tablets,ambroxol expanded bronchus.On the basis of control group,the patients of study group were treated with tiotropium bromide inhalation powder（18μg/time,1 time/d）.The patients of two groups were all treated for 8 weeks.The clinical efficacy and changes of the levels of lung function,TNF-a and IL-6 of two groups were compared.Results After the appropriate treatment,the patients of the study group got a total effective rate of 89.6%,which was significantly better than the 72.9%of the control group（χ^2=4.376,P = 0.036）;In the terms of FEV1,FVC,FEV1%,PaO2,the patients of two groups were all significantly increased than before,and the patients of the study group got more significant increase（t =3.148,t =6.012,t = 5.994,t = 17.414,P〈0.05）;In the terms of PaCO2,TNF-α,IL-6,IL-10,the patients of two groups were all significantly decreased than before,and the patients of the study group got more significant decline（t =7.447,t =5.507,t =1.821,t =4.381 P〈0.05）.Conclusion With treating elderly patients with chronic obstructive pulmonary disease,tiotropium bromide can get the exact effect,improve the lung function of patients,reduce the inflammatory response state,and it is also safe and reliable,which makes it worthy of clinical application.

关 键 词：噻托溴铵 慢性阻塞性肺疾病 肺功能 肿瘤坏死因子-Α 白细胞介素-6 老年 

分 类 号：R563.9[医药卫生—呼吸系统]