噻托溴铵与沙美特罗替卡松联合吸入治疗稳定期慢性阻塞性肺疾病的疗效观察  

Observation on Efficacy of Tiotropium Bromide Combined with Seretide for Inhalation in Treatment of Chronic Obstructive Pulmonary Disease in Stable Phase

作　　者：耿培娜 张龙 曹丽丽 童成刚 GENG Peina;ZHANG Long;CAO Lili;TONG Chenggang(The Cadre Ward, the 71st Army Hospital of PLA, Jiangsu Xuzhou 221004, China;Dept.of Neurology, the 71st Army Hospital of PLA, Jiangsu Xuzhou 221004, China)

机构地区：[1]解放军陆军第七十一集团军医院干部病房,江苏徐州221004 [2]解放军陆军第七十一集团军医院神经内科,江苏徐州221004

出　　处：《中国医院用药评价与分析》2019年第4期448-450,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨噻托溴铵与沙美特罗替卡松联合吸入治疗稳定期慢性阻塞性肺疾病的临床疗效。方法:选取2017年1月至2018年9月解放军陆军第七十一集团军医院收治的稳定期慢性阻塞性肺疾病患者86例,采用分层随机抽样法分为观察组和对照组,每组43例。对照组患者给予噻托溴铵治疗,观察组患者给予噻托溴铵联合沙美特罗替卡松治疗。持续治疗90 d后,比较两组患者的血清免疫指标水平、肺功能指标[动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)及1 s用力呼气容积占用力肺活量百分比(FEV_1/FVC)]水平、6 min步行距离(6MWT)及临床疗效的差异。结果:治疗后,观察组患者CD3^+、CD4^+、CD8^+及CD4^+/CD8^+水平明显优于治疗前和对照组治疗后,差异均有统计学意义(P<0.05)。治疗后,两组患者的PaO_2、FEV_1/FVC及6MWT水平较治疗前明显提高,PaCO_2水平明显降低;且观察组患者PaO_2、PaCO_2、FEV_1/FVC及6MWT水平明显优于对照组,差异均有统计学意义(P<0.05)。观察组患者的总有效率为90.7%(39/43),明显高于对照组的79.1%(34/43),差异有统计学意义(P<0.05)。结论:噻托溴铵与沙美特罗替卡松联合吸入疗法治疗稳定期慢性阻塞性肺疾病的疗效显著,能提高机体免疫水平,且对改善患者肺功能及缓解临床症状具有积极意义。OBJECTIVE: To probe into the efficacy of tiotropium bromide combined with seretide for inhalation in treatment of chronic obstructive pulmonary disease(COPD) in stable phase. METHODS: 86 patients with COPD in stable phase admitted into the 71 st Army Hospital of PLA from Jan. 2017 to Sept. 2018 were selected and divided into observation group and control group via stratified random sampling, with 43 cases in each group. The control group was treated with tiotropium bromide, while the observation group was given tiotropium bromide combined with seretide. After 90-day treatment, differences in serum immune indices, pulmonary function indices [arterial partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2) and the proportion of 1 s forced expiratory volume accounted for forced vital capacity(FEV1/FVC)], 6 min walking test(6 MWT) and clinical efficacy between two groups were compared. RESULTS: After treatment, the CD3^+, CD4^+, CD8^+ and CD4^+/CD8^+ levels of observation group were significantly better than those of before treatment and the control group, with statistically significant differences(P<0.05). After treatment, the PaO2, FEV1/FVC and 6 MWT levels of both groups had been significantly improved, with significantly lower PaCO2 level;the PaO2, PaCO2, FEV1/FVC and 6 MWT levels of observation group were significantly better than those of the control group, with statistically significant differences(P<0.05). The total effective rate of observation group was 90.7%(39/43), which was significantly higher than that of the control group(79.1%, 34/43), with statistically significant difference(P<0.05). CONCLUSIONS: The efficacy of tiotropium bromide combined with seretide for inhalation in treatment of COPD in stable phase is remarkable, which can increase immune level, with positive significance for improving pulmonary function and relieving clinical symptoms.

关 键 词：噻托溴铵 沙美特罗替卡松 COPD 免疫水平 肺功能 疗效 

分 类 号：R974[医药卫生—药品]