噻托溴铵干粉剂吸入对急性加重期慢性阻塞性肺疾病患者肺部感染BODE指数的影响  

Effect of tiotropium bromide dry powder inhalation on BODE index of pulmonary infection in patients with acute exacerbation chronic obstructive pulmonary disease

作　　者：庞晶琳[1] 于继云 张欢欢 郑华德[1] PANG Jing-lin;YU Ji-yun;ZHANG Huan-huan;ZHENG Hua-de(Department of Respiratory,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Department of Cadre,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China;Biological Treatment Frontier Technology Research Office,Academy of Military Sciences,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心呼吸科,北京100048 [2]解放军总医院第四医学中心干部科,北京100048 [3]军事科学院生物治疗前沿技术研究室,北京100048

出　　处：《实用药物与临床》2020年第10期897-900,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究噻托溴铵干粉剂吸入对急性加重期慢性阻塞性肺疾病(AECOPD)患者肺部感染BODE指数的影响。方法纳入解放军总医院第四医学中心2016年3月至2019年3月80例AECOPD患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组40例。两组均行常规治疗,观察组加用噻托溴铵干粉剂。比较两组总体治疗效果,记录两组治疗前后BODE指数。出院随访半年,记录肺部感染发生率,分析BODE指数判断肺部感染的价值。结果观察组总有效率为97.5%,对照组为90%,两组总有效率比较,差异无统计学意义(P>0.05)。治疗后两组FEV1%pred和6MWT较治疗前均显著升高,MMRC和BODE指数评分较治疗前均显著降低,差异均有统计学意义(P<0.05)。治疗后观察组FEV1%pred和6MWT均高于对照组,MMRC和BODE指数评分均低于对照组,差异均有统计学意义(P<0.05)。两组治疗前后BMI比较,差异无统计学意义[治疗前:(21.85±2.02)kg/m 2 vs.(21.76±2.21)kg/m 2;治疗后:(22.07±1.85)kg/m 2 vs.(22.13±1.97)kg/m 2,P>0.05]。观察组肺部感染发生率低于对照组,差异有统计学意义(5.00%vs.22.50%,P<0.05)。ROC分析显示,BODE指数判断肺部感染的AUC为0.733(β=0.086,95%CI:0.563~0.902,P=0.014)。结论噻托溴铵干粉吸入剂用于AECOPD患者有助于降低BODE指数水平,监测BODE指数有助于预测肺部感染,指导临床。Objective To study the effect of tiotropium bromide dry powder inhalation on BODE index of pulmonary infection in patients with acute exacerbation chronic obstructive pulmonary disease(AECOPD).Methods Totally 80 patients with AECOPD from March 2016 to March 2019 in the Fourth Medical Center of PLA General Hospital were included as the study subjects.The patients were divided into observation group and control group by random number table method(n=40).The two groups were treated routinely,and the observation group also treated with tiotropium bromide dry powder.The overall therapeutic effect was compared between the two groups,and the BODE indexes were recorded before and after treatment.The incidence of pulmonary infection was recorded by a follow-up of half a year,and the value of BODE index in judging pulmonary infection was analyzed.Results The total effective rate was 97.5%in observation group and 90%in control group,and the difference was not statistically significant(P>0.05).The FEV1%pred and 6MWT in the two groups were significantly higher after treatment than those before treatment(P<0.05),while the MMRC and BODE index scores were significantly lower than those before treatment(P<0.05).After treatment,the FEV1%pred and 6MWT of observation group were higher than those of control group,while the scores of MMRC and BODE index were lower than those of control group,the difference being statistically significant(P<0.05).There was no significant difference in BMI between the two groups before and after treatment(P>0.05).The incidence rate of pulmonary infection in observation group was lower than that in control group,and the difference was statistically significant(5.00%vs.22.50%,P<0.05).The ROC analysis showed that the AUC of BODE index in judging pulmonary infection was 0.733(β=0.086,95%CI=0.563~0.902,P=0.014).Conclusion The tiotropium bromide dry powder inhalation is helpful to reduce the level of BODE index in patients with AECOPD.Monitoring BODE index helps to predict pulmonary infection and guide clinic

关 键 词：噻托溴铵 慢性阻塞性肺疾病 肺部感染 BODE指数 

分 类 号：R563.9[医药卫生—呼吸系统]