稳定期慢性阻塞性肺疾病患者小气道改变及对吸入性药物的疗效反应  

Small airway changes and curative response to inhaled drugs in patients with stable chronic obstructive pulmonary disease

作　　者：王丽萍 黄宜谋 张丽娃 WANG Li-ping;HUANG Yi-mou;ZHANG Li-wa(Shanwei Yihui Foundation Hospital,Shanwei 516600,China)

机构地区：[1]汕尾逸挥基金医院全科医学科,广东汕尾516600

出　　处：《中国处方药》2023年第5期10-12,共3页Journal of China Prescription Drug

基　　金：汕尾市科技计划项目(210528156342004)。

摘　　要：目的探讨稳定期慢性阻塞性肺疾病(COPD)患者小气道改变及对吸入性药物的疗效反应。方法选取2021年4月~2021年12月某院收治的60例符合研究条件的稳定期COPD患者,全部患者均行高分辨率CT(HRCT)检查,测量3级支气管壁厚度(WT)与伴行肺动脉直径(BWT),计算WT/BWT,比较观察不同气流受限严重程度患者的指标差异。随机数字表法将入选病例分为丙酸倍氯米松组和布地奈德组各30例,分别予以倍氯米松福莫特罗气雾剂、布地奈德福莫特罗吸入粉雾剂治疗。治疗前后,两组均行6 min步行试验(6MWT),测定6 min步行距离(6MWD);行肺通气功能检查,测定肺功能指标用力肺活量(FVC)、第1秒用力呼气容积(FEV1),计算1秒率(FEV1/FVC);行HRCT检查,测量WT与BWT,计算WT/BWT,观察指标差异。结果60例患者WT随着COPD全球防治策略(GOLD)分级的增加而升高,但差异无统计学意义(P>0.05);BWT随着GOLD分级的增加而下降,差异有统计学意义(P<0.05)。两组治疗后6MWD、FVC、FEV1均较治疗前提高,WT与BWT均较治疗前降低,但差异无统计学意义(P>0.05)。结论稳定期COPD患者小气道壁厚与伴行肺动脉直径可以反映病情严重程度,予以倍氯米松福莫特罗气雾剂或布地奈德福莫特罗吸入粉雾剂治疗,可以改善小气道阻力,提高患者肺通气功能与活动耐力,临床疗效相当。Objective To investigate the small airway changes and the curative response to inhaled drugs in patients with stable chronic obstructive pulmonary disease.Methods A total of 60 patients with stable COPD who were eligible for the study from April 2021 to December 2021 were selected.All patients underwent high-resolution CT(HRCT)examinations,measured grade 3 bronchial wall thickness(WT)and accompanying Pulmonary artery diameter(BWT),calculated WT/BWT,compared and observed the differences of indicators in patients with different severity of airflow limitation.The selected cases were divided into beclomethasone propionate group and budesonide group,30 cases in each group.The beclomethasone propionate group was treated with beclomethasone and formoterol aerosol,budesonide group was treated with budesonide and formoterol fumarate powder for inhalation.Before and after treatment,both groups underwent 6-min walking test(6MWT),the 6-min walking distance(6MWD)was measured.The pulmonary ventilation function was checked,the forced vital capacity(FVC)and the forced expiratory volume in the first second(FEV1)were measured,and the one-second rate(FEV1/FVC)was calculated.Before and after treatment,HRCT was performed to measure WT and BWT,and WT/BWT was calculated,observed the differences in indicators.Results In 60 patients,WT increased with the increase of GOLD grade,the difference was no statistically significan(t P>0.05)and BWT decreased with the increase of GOLD grade,the difference was statistically significant(P<0.05).After treatment,6MWD,FVC,and FEV1 in the two groups were increased compared with those before treatment,while WT and BWT were decreased compared with those before treatment,and the differences was no statistically significant(P>0.05).Conclusion Small airway wall thickness and accompanying pulmonary artery diameter in patients with stable COPD can reflect the severity of the disease,and treated with beclomethasone and formoterol aerosol or budesonide and formoterol fumarate powder for inhalation can reduce sma

关 键 词：慢性阻塞性肺疾病 稳定期 小气道 吸入性药物 疗效 

分 类 号：R563.9[医药卫生—呼吸系统]