曲前列尼尔联合沙美特罗替卡松对慢性阻塞性肺疾病合并重症肺动脉高压患者的临床应用分析  

Clinical Application of Treprostinil in Combination with Salmeterol and Ficasone in Patients with Chronic Obstructive Pulmonary Disease and Severe Pulmonary Hypertension

作　　者：胡小春 刘时武[1] 滕丽峰 叶丛 张如俊 HU Xiaochun;LIU Shiwu;TENG Lifeng(Hainan Provincial People's Hospital, Hainan Haikou 570311, China)

机构地区：[1]海南省人民医院心血管内科,海南海口570311

出　　处：《河北医学》2022年第3期513-518,共6页Hebei Medicine

基　　金：2015年度海南省自然科学基金项目,(编号:20158340)。

摘　　要：目的:探讨曲前列尼尔联合沙美特罗替卡松对慢性阻塞性肺疾病(COPD)合并重症肺动脉高压(PAH)患者的临床运用效果。方法:选择我院2018年1月至2021年1月收治的COPD合并重症PAH患者147例进行研究,采用随机数字表法进行简单随机分组,共分为研究组和对照组两组,研究组77例,对照组70例,给予对照组曲前列尼尔注射液治疗,研究组在此基础上联合应用沙美特罗替卡松粉剂治疗,两组均治疗21d,比较两组临床疗效、肺功能指标[第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%pred)和第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)]、血浆中一氧化氮(NO)、内皮素(ET-1)、可溶性鸟苷酸环化酶(cGMP)、腺苷酸环化酶(cAMP)含量、血清炎性因子[Apelin、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平、不良反应发生情况。结果:研究组与对照组总有效率分别为93.51%和78.57%(P<0.05);研究组治疗前后FEV1/FVC和FEV1%pre、NO、ET-1、cGMP、cAMP、hs-CRP、TNF-α、Apelin差值均高于对照组治疗前后差值(P<0.05);两组不良反应无显著差异(P>0.05)。结论:曲前列尼尔联合沙美特罗替卡松治疗慢性阻塞性肺疾病合并重症肺动脉高压具有显著疗效,在提升肺功能、降低炎症反应方面具有较大优势,适合推广应用。Objective:To explore the clinical effect of treprostinil in combination with salmeterol on patients with chronic obstructive pulmonary disease(COPD)and severe pulmonary hypertension(PAH).Methods:A total of 147 COPD patients with severe PAH admitted to our hospital from January 2018 to January 2021 were selected for the study.The random number table method was used for simple random grouping,and they were divided into two groups:study group and control group,with 77 cases in study group.In the control group,70 cases were treated with Trepronil injection.The study group was combined with salmeterol and ticasone powder on this basis.Both groups were treated for 21 days.The clinical efficacy,pulmonary function parameters[1st second expiratory volume(FEV1)as a percentage of predicted value(FEV1%pred)and 1st second expiratory volume to expiratory spirometry ratio(FEV1/FVC)],plasma levels of nitric oxide(NO),endothelin(ET-1),soluble guanylate cyclase(cGMP),adenylate cyclase(cAMP),serum inflammatory factors[Apelin,tumour necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)],and the occurrence of adverse reactions between the two groups were compared.Results:The total effective rates of the study group and the control group were 93.51%and 78.57%respectively(P<0.05);the difference in FEV1/FVC and FEV1%pre,NO,ET-1,cGMP,cAMP,hs-CRP,TNF-αand Apelin before and after treatment in the study group was higher than the difference before and after treatment in the control group(P<0.05);there was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Treprostinil in combination with salmeterol and ticassone has significant effects in the treatment of chronic obstructive pulmonary disease complicated with severe pulmonary hypertension.It has great advantages in improving lung function and reducing inflammation,and is suitable for popularization and application.

关 键 词：慢性阻塞性肺疾病 曲前列尼尔 沙美特罗替卡松 重症肺动脉高压 炎性因子 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统] R544.1[医药卫生—内科学]