噻托溴铵粉吸入剂治疗支气管扩张并呼吸衰竭的疗效观察  

Observation of curative effect of tiotropium bromide inhalation in treatment of bronchiectasis patients complicated with respiratory failure

作　　者：郭伟洪[1] 袁小玲[1] 吕燕华[1] 缪炯燏[1] 黄锡坤[1] 

机构地区：[1]中山市人民医院呼吸内科,广东中山528400

出　　处：《临床肺科杂志》2017年第8期1372-1374,1379,共4页Journal of Clinical Pulmonary Medicine

基　　金：广东省医学科学技术研究基金(No 2015007);中山市科技计划项目(No 2014A1FC090)

摘　　要：目的探讨噻托溴铵粉吸入剂治疗支气管扩张并呼吸衰竭的治疗效果。方法 60例支气管扩张并呼吸衰竭患者随机分为两组各30例,一组为对照组,予支气管扩张症及呼吸衰竭常规治疗;另一组为试验组,常规治疗基础上加用噻托溴铵粉吸入剂18ug qd,疗程3个月。收集患者的一般资料及治疗前后的疗效观察指标,包括呼吸困难症状评分(m MRC)、肺功能指标(FVC%、FEV_1%)、血气分析指标(PO_2,PCO_2)、3个月内急性加重次数,比较治疗前后两组患者疗效指标的差异。结果治疗后两组患者m MRC评分、FVC%、FEV_1%、PO_2、PCO_2均较治疗前有显著改善(P>0.05),并且试验组较对照组更能降低患者的mMRC评分及PCO_2(P<0.05),但在改善FVC%、FEV_1%、PO_2及急性加重次数方面两组间无显著差异(P>0.05)。结论噻托溴铵粉吸入剂可显著改善支气管扩张并呼吸衰竭患者的呼吸困难症状,改善高碳酸血症减轻呼吸衰竭,但对肺功能及急性加重风险的影响有待进一步研究。Objective To investigate the curative effect of tiotropium bromide inhalation in treatment of bronchiectasis patients complicated with respiratory failure.Methods 60 bronchiectasis patients complicated with respiratory failure were randomly divided into 2 groups： the control group （n=30） and the trail group （n=30）.Each group received conventional therapy.Besides, the trail group was treated with tiotropium 18 μg QD inhalation and the course of treatment was 3 months.We recorded the general condition and the therapeutic index, including dyspnea symptom score （mMRC）, pulmonary function （FVC%, FEV1%）, blood gas analysis （PO2, PCO2） before and after treatment, and the times of acute exacerbation in 3 months.After treatment, the differences of the therapeutic index and the times of acute exacerbation were compared between the two groups.Results mMRC score, FVC%, FEV1%, PO2 and PCO2 were all improved in both groups after treatment （P〈0.05）.The reduction of mMRC and PCO2 were significant higher in the trail group than in the control group, while the improvement of FVC%, FEV1%, PO2 and the number of acute attack had no significant difference between the two groups （P〉0.05）.Conclusion Tiotropium bromide inhalation can improve the symptom of dyspnea, reduce the blood PCO2 level and improve respiratory failure, but there need more study to discuss its effect on lung function and acute exacerbation risk.

关 键 词：噻托溴铵 支气管扩张 呼吸衰竭 

分 类 号：R562.22[医药卫生—呼吸系统] R563.9[医药卫生—内科学]