布地奈德福莫特罗、噻托溴铵、家庭无创正压通气对慢性阻塞性肺疾病患者影响的研究  

Effect of budesonide-formoterol and tiotropium bromide and long term home non-invasive positive pressure ventilation( NIPPV) in patients with stable COPD

作　　者：刘颖[1] 薄晓霞[1] 张亚娟[1] LIU Ying;BO Xiao-xia;ZHANG Ya-juan(Department of Respiratory Medicine,the Third Affiliated Hospital of Baotou Medical College,Baotou 014000,China)

机构地区：[1]包头医学院第三附属医院,内蒙古包头014000

出　　处：《临床肺科杂志》2018年第8期1394-1397,共4页Journal of Clinical Pulmonary Medicine

基　　金：包头市医药卫生科技发展基金(wsjj2016077)

摘　　要：目的比较布地奈德福莫特罗、噻托溴铵以及布地奈德福莫特罗联合家庭无创正压通气对稳定期慢性阻塞性肺疾病患者的影响。方法选取2015年1月至2017年1月我院收治的42例气流受限程度为中度及以上的慢性阻塞性肺疾病患者,经治疗进入疾病稳定期后将患者按照数字分配原则随机分为A、B、C组,各14例。A组给予布地奈德福莫特罗干粉(每日2次,每次320/9微克)联合噻托溴铵粉(每日1次,每次18微克)吸入治疗,B组给予噻托溴铵粉吸入治疗(每日1次,每次18微克),C组在A组的基础上联合家庭无创正压通气治疗。随访1年,比较上述3组患者慢性阻塞性肺疾病评估测试(CAT)呼吸问卷评分、血气分析指标、慢性阻塞性肺病急性加重并住院治疗次数、住院时间、随访期间住院治疗费用、死亡率。结果治疗前3组患者CAT评分、PO_2、PCO_2差异无统计学意义(P>0.05),治疗1年后3组患者CAT评分、PO_2、PCO_2均较治疗前改善,差异有统计学意义(P<0.05),C组CAT评分、PO_2、PCO_2、疾病急性加重并住院治疗次数、住院时间、随访期间住院治疗费用较其余两组改善明显,差异有统计学意义(P<0.05),A组与B组组间比较差异无统计学意义(P>0.05);随访期间A、B、C组各死亡1例,3组患者死亡率比较差异无统计学意义(P>0.05)。结论长效支气管舒张药物配合正规吸入技术可有效改善患者症状及血气指标,家庭无创正压通气可进一步降低疾病急性加重并住院治疗次数以及住院花费,提高患者生活质量,降低医疗成本。Objective To evaluate the difference among budesonide-formoterol and tiotropium bromide and budesonide-formoterol combined with long term home non-invasive positive pressure ventilation（ NIPPV） in patients with stable COPD. Methods 42 stable COPD patients with airflow limitation of GOLD（ Global initiative of chronic Obstructive Lung Disease） stage 2 or worse in our hospital from January 2015 to January 2017 were selected,and they were evenly divided into the groups A,B and C randomly. The group A was given budesonide-formoterol combined with tiotropium bromide,the group B was given tiotropium bromide,and the group C was given budesonide-formoterol combined with tiotropium bromide and long term home non-invasive positive pressure ventilation（ NIPPV）.COPD Assessment Test（ CAT） respiratory questionnaire score and arterial blood gas were compared before and after treatment. The rate of AECOPD and hospital admission,duration of hospital stay（ LOS）,hospital cost and mortality were compared among the three groups. Results Before treatment,CAT respiratory questionnaire and arterial blood gas in the 3 groups were compared,and the difference among the three groups was not significant（ P〉0. 05）. CAT cores,PO2 and PCO2 were significantly improved after one year in the C group（ P〈0. 05）,while compared with the group A and B. Moreover,the rate of AECOPD and hospital admission,duration of hospital stay（ LOS）,and hospital cost reduced more obviously in the group C than in the group A and B（ P〈0. 05）,but they were not significant between the group A and the group B（ P〉0. 05）. Conclusion Combined with regular inhalation,long-acting inhaled bronchodilators can improve the symptoms and arterial blood gas,and long term home non-invasive positive pressure ventilation（ NIPPV） can further reduce exacerbation rate and cost and improve the quality of life.

关 键 词：长效支气管舒张药物 吸入技术 家庭无创正压通气 慢阻肺稳定期 

分 类 号：R563.9[医药卫生—呼吸系统]