噻托溴铵粉吸入剂联合茶碱对COPD稳定期患者气道重塑及肺功能的影响  

Effects of tiotropium bromide inhalation powder combined with theophylline on airway remodeling and lung function in patients with stable COPD

作　　者：王娜[1] 张琳[1] 徐海丽[1] WANG Na;ZHANG Lin;XU Hai-li(Department of Inner Division 3,Beijing Municipality Corps Hospital of PAP,Beijing 100027,China)

机构地区：[1]武警北京总队医院内三科

出　　处：《武警后勤学院学报（医学版）》2018年第11期929-932,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨噻托溴铵粉吸入剂联合茶碱对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者气道重塑及肺功能的影响。【方法】选择2015 年2 月至2016 年3 月我院收治的80 例COPD 稳定期患者,按随机数字表法分为两组,每组40 例。对照组予以口服茶碱缓释片治疗,在此基础上观察组予以噻托溴铵粉吸入剂治疗。治疗8 周后,比较两组患者肺功能[第1 秒钟用力呼气量(forced expiratory volume in 1 second,FEV1)、FEV1/用力肺活量(forced vital capacity,FVC)、FEV1占预计值的百分比(FEV1%Pred)]、生活质量、运动耐力、气道重塑[白介素-8(interleukin 8,IL-8)、基质金属蛋白酶-9(matrixmetalloproteinase 9,MMP-9)],并评价两组用药安全性。【结果】对照组FEV1%Pred、FEV1、FEV1/FVC 水平均低于观察组,差异具有统计学意义(P<0.05);观察组中6 min 步行距离(six-minutes walk distance,6MWD)与对照组相比更长,圣乔治呼吸疾病问卷(St.George's respiratory questionnaire,SGRQ)评分低于对照组,差异具有统计学意义(P<0.05);对照组中MMP-9、IL-8 水平显著高于对照组,差异具有统计学意义(P<0.05);对照组不良反应发生率2.5%(1/40)与观察组7.5%(3/40)相比,差异无统计学意义(P>0.05)。【结论】对COPD 稳定期患者采用噻托溴铵粉吸入剂联合茶碱治疗,能有效改善患者肺功能,降低气道重塑,提高生活质量,且不会增加毒副反应,安全性较高。【Objective】To explore the effects of tiotropium bromide inhalation powder combined with theophylline on airway remodeling and lung function in patients with stable chronic obstructive pulmonary disease (COPD).【Methods】A total of 80 stable COPD patients in our hospital from February 2015 to March 2016 were selected,and divided into two groups by random number table,40 cases per group.The patients in the control group were given theophylline sustained-release tablets,while those in the observation group were treated with tiotropium bromide powder for inhalation based on the treatment for the control group.After 8 w treatment,the lung function [forced expiratory volume in 1st second (FEV1),forced vital capacity (FVC),FEV1%Pred],quality of life,exercise tolerance,airway remodeling [interleukin 8 (IL-8), matrix metalloproteinase 9 (MMP-9)] were compared between the two groups,and the safety of medication in two groups were evaluated.【Results】The levels of FEV1%Pred,FEV1,FEV1/FVC in the control group were lower than those in the observation group (P<0.05).The six-minute walk distance (6MWD) in the observation group was longer than that in the control group,while the score of St.George's respiratory questionnaire (SGRQ) in the observation group was lower than that in the control group (P<0.05).The levels of MMP-9,IL-8 in the control group were significantly higher than those in the control group (P<0.05).The incidence of adverse reactions in the control group [2.5%(1/40)] and observation group [7.50%(3/40)] had no statistical difference (P>0.05).【Conclusion】Tiotropium bromide powder for inhalation combined with theophylline in the treatment of stable COPD can improve lung function,decrease airway remodeling,increase quality of life.Moreover, it will not increase toxic-side effects.It is of higher safety.

关 键 词：噻托溴铵粉吸入剂 茶碱 慢性阻塞性肺疾病 气道重塑 肺功能 

分 类 号：R974[医药卫生—药品]