不同β受体激动剂联合阿托伐他汀治疗COPD合并冠状动脉粥样硬化心脏病患者临床疗效的对比研究  

Combination of different Beta receptor agonists and atorvastatin in treatment of patients with COPD and coronary atherosclerotic heart disease

作　　者：叶斌[1] 叶波[2] YE Bin;YE Bo(Respiratory department of Chengdu first people's Hospital,Chengdu Sichuan 610095,China;Laboratory Department of Sichuan Cancer Hospital,Chengdu Sichuan 610042,China)

机构地区：[1]成都市第一人民医院呼吸科,四川成都610095 [2]四川省肿瘤医院检验科,四川成都610042

出　　处：《转化医学杂志》2022年第5期300-305,共6页Translational Medicine Journal

摘　　要：目的探讨布地格福与硫酸特布他林联合应用阿托伐他汀治疗慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)合并冠状动脉粥样硬化心脏病患者的疗效、肺功能和氧化应激水平的差异研究。方法本研究前瞻性选择2019年1月-2021年12月成都市第一人民医院收治的慢性阻塞性肺疾病COPD合并冠状动脉粥样硬化心脏病患者104例,依据随机数表法将所有纳入患者分为治疗A组、治疗B组,每组各52例。治疗A组予以阿托伐他汀+硫酸特布他林雾化液,治疗B组用阿托伐他汀+布地格福吸入雾化剂干预,观察比较干预前后各组纳入患者的临床疗效、临床症状缓解时间、血清炎性水平、血浆内皮素-1(endothelin-1,ET-1)与脑钠肽(brain natriuretic peptide,BNP)水平、肺功能、氧化应激水平以及药物安全性,并且随访6个月记录心血管事件(急性心肌梗死、心力衰竭、新发心绞痛)的发生率。结果治疗B组接受联合干预方案后的临床治疗有效率为92.3%,高于治疗A组69.2%(χ^(2)=8.914,P<0.05)。治疗B组接受联合干预方案后的咳嗽缓解时长、喘息缓解时长及肺啰音消失时长等指标均短于治疗A组(P<0.05)。干预后两组患者肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-8(Interleukin-8,IL-8)与白细胞介素-6(Interleukin-6,IL-6)水平较干预前均下降(P<0.05),且干预后治疗B组患者的TNF-α、IL-8与IL-6水平均低于治疗A组(P<0.05)。干预后两组患者血浆ET-1和BNP水平较干预前均改善(P<0.05),且干预后治疗B组患者的血浆ET-1和BNP水平低于治疗A组(P<0.05)。干预后两组患者的肺功能较干预前有了明显改善(P<0.05),且干预后治疗B组患者的第一秒用力呼气容积(Forced expiratory volume in one second,FEV1)、第一秒用力呼气容积占预计值的百分比(Forced expiratory volume in one second percentage,FEV1%)、FEV1/用力肺活量(Forced vital capacity,FVC)水平则高于治疗A组(P<0.05Objectives To investigate the efficacy of different Beta receptor agonists combined with atorvastatin in treatment of Chronic obstructive pulmonary disease(COPD)patients with coronary atherosclerotic heart disease.Methods This study prospectively selected 104 patients with COPD combined with coronary atherosclerotic heart disease who were treated in our hospital from January 2019 to December 2021.All the included patients were divided into treatment group A and treatment group B by random number table method with 52 cases in each group.Treatment group A was given atorvastatin and terbutaline sulfate nebulized liquid,and treatment group B was given atorvastatin and Budesonide inhalation aerosol for intervention.The clinical efficacy and clinical symptoms of the included patients in each group before and after the intervention were observed and compared.The serum inflammatory level,plasma endothelin-1(ET-1)and brain natriuretic peptide(BNP)levels,lung function,oxidative stress level,and drug safety,and the cardiovascular events(acute myocardial infarction,heart failure,new-onset angina)were recorded during 6-month follow-up.Results The effective rate of clinical treatment in the group B after receiving the combined intervention program was 92.3%,which was higher than that in the group A 69.2%(χ^(2)=8.914,P<0.05).The duration of wheezing relief and the duration of pulmonary rales disappearing in the group B were shorter than these in the group A(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),and interleukin-6(IL-6)in the two groups after intervention were lower than these before intervention(P<0.05).And the levels of TNF-α,IL-8,and IL-6 in the group B were lower than these in the group A after intervention(P<0.05);After intervention,the plasma ET-1 and BNP levels of the patients in the group B were lower than these in the treatment group A(P<0.05).The lung function of patients in the two groups was significantly improved(P<0.05)after intervention,and the levels of forced expiratory volu

关 键 词：Β2受体激动剂 阿托伐他汀 慢性阻塞性肺病 肺功能 心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病] R563[医药卫生—内科学]