特布他林联合噻托溴铵对慢性阻塞性肺疾病患者HIF1、γ-GCS水平的影响  

The effect of terbutaline combined with tiotropium bromide on HIF1 andγ-GCS levels in patients with chronic obstructive pulmonary disease

作　　者：王莉[1] 汪诚[1] 叶盛[1] 冯起甲[1] 蒋鹏 Wang Li;Wang Cheng;Ye Sheng;Feng Qijia;Jiang Peng(Department of Respiration,Nanjing Mingji Hospital Affiliated to Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属南京明基医院呼吸科,210019

出　　处：《疑难病杂志》2020年第10期1009-1012,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察特布他林联合噻托溴铵对慢性阻塞性肺疾病(COPD)患者低氧诱导因子1(HIF1)、γ-谷氨酰半胱氨酸合酶(γ-GCS)的影响。方法选取2018年1月—2019年5月南京医科大学附属南京明基医院呼吸科收治的COPD患者120例,按随机数字表法分为噻托溴铵组、联合用药组,每组60例。噻托溴铵组在常规治疗基础上给予噻托溴铵,联合用药组在噻托溴铵组基础上再加用特布他林。比较2组患者治疗总有效率,治疗前后γ-GCS、HIF1水平、肺功能、炎性因子水平,以及不良反应发生率。结果联合用药组治疗总有效率高于噻托溴铵组(93.33%vs.78.33%,χ^2/P=5.551/0.018);治疗后联合用药组γ-GCS、HIF1表达低于噻托溴铵组(t/P=14.511/0.001、2.239/0.027);联合用药组FEV 1/FVC、FEV 1、FVC及PaO 2水平高于噻托溴铵组(t/P=2.129/0.035、4.687/0.001、3.378/0.001、9.434/0.001),而PaCO 2低于噻托溴铵组(t/P=5.587/0.001);治疗后联合用药组CRP、TNF-α水平低于噻托溴铵组(t/P=5.431/0.001、7.192/0.001);联合用药组不良反应发生率高于噻托溴铵组,但差异无统计学意义(χ^2/P=2.157/0.142)。结论特布他林联合噻托溴铵治疗COPD效果显著,可降低HIF1、γ-GCS水平,改善患者肺功能。Objective To observe the effects of terbutaline combined with tiotropium bromide on hypoxia inducible factor 1(HIF1)andγ-glutamylcysteine synthase(γ-GCS)in patients with chronic obstructive pulmonary disease(COPD).Methods From January 2018 to May 2019,120 COPD patients admitted to the Department of Respiratory Medicine,Nanjing BenQ Hospital,Nanjing Medical University,were selected and divided into tiotropium bromide group and combination medication group according to a random number table,with 60 cases in each group.Tiotropium bromide group was given tiotropium bromide on the basis of conventional treatment,and the combination group was given terbutaline on the basis of tiotropium bromide group.The total effective rate of treatment,γ-GCS,HIF1 levels,lung function,inflammatory factor levels,and the incidence of adverse reactions before and after treatment were compared between the two groups.Results The total effective rate of treatment in the combination group was higher than that in the tiotropium bromide group(93.33%vs.78.33%,χ^2/P=5.551/0.018);after treatment,the expression ofγ-GCS and HIF1 in the combination group was lower than that in the tiotropium bromide group(t/P=14.511/0.001,2.239/0.027);FEV 1/FVC,FEV 1,FVC and PaO 2 levels in the combination group were higher than those in the tiotropium bromide group(t/P=2.129/0.035,4.687/0.001,3.378/0.001,9.434/0.001),while PaCO 2 was lower than the tiotropium bromide group(t/P=5.587/0.001);after treatment,the CRP and TNF-αlevels in the combination group were lower than the tiotropium bromide group(t/P=5.431/0.001,7.192/0.001);the incidence of adverse reactions in the combination group was higher than that in the tiotropium bromide group,but the difference was not statistically significant(χ^2/P=2.157/0.142).Conclusion Terbutaline combined with tiotropium bromide has a significant effect on the treatment of COPD,which can reduce the levels of HIF1 andγ-GCS and improve the lung function of patients.

关 键 词：特布他林 噻托溴铵 慢性阻塞性肺疾病 低氧诱导因子1 Γ-谷氨酰半胱氨酸合酶 

分 类 号：R563.9[医药卫生—呼吸系统]