噻托溴铵联合经支气管镜大容量肺灌洗对尘肺病合并慢性阻塞性肺疾病患者气道炎症反应及肺功能的影响  

Effect of tiotropium bromide combined with bronchoscopic large volume lung lavage on airway inflammation and pulmonary function in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease

作　　者：蔡如华 李金阳 李怀忠 CAI Ruhua;LI Jinyang;LI Huaizhong(Department of Occupational Disease Prevention and Management,Jingdezhen Disease Prevention and Control Center,Jingdezhen,Jiangxi,333000,China;Department of Respiratory,Zhushan New Factory Hospital,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇市疾病预防控制中心职业病预防管理科,江西景德镇333000 [2]珠山新厂医院呼吸内科,江西景德镇333000

出　　处：《当代医学》2022年第33期125-128,共4页Contemporary Medicine

基　　金：江西省卫生计划委科技计划(NO.20156066)。

摘　　要：目的探究噻托溴铵联合经支气管镜大容量肺灌洗对尘肺病合并慢性阻塞性肺疾病(COPD)患者气道炎症反应及肺功能的影响。方法选取2019年11月至2020年12月景德镇市疾病预防控制中心、珠山新厂医院收治的126例尘肺病合并COPD患者作为研究对象,按随机数字表法分为两组,各63例。对照组采用噻托溴铵治疗,观察组在此基础上实施经支气管镜大容量肺灌洗。比较两组气道炎症反应、肺功能及不良反应发生率。结果治疗前,两组气道炎症反应及肺功能比较差异无统计学意义;治疗后,观察组肿瘤坏死因子α(TNF-α)、白细胞介素-8(IL-8)及白细胞介素-6(IL-6)水平均低于对照组,第1秒用力呼气容积(FEV_(1))、呼气峰流速值(PEF)、用力肺活量(FVC)及每分钟最大通气量(MVV)均高于对照组,差异有统计学意义(P<0.05)。两组不良反应比较差异无统计学意义。结论噻托溴铵联合经支气管镜大容量肺灌洗能够减轻尘肺病合并COPD患者的气道炎症反应,促进肺功能改善,且不良反应少,值得临床推广应用。Objective To investigate the effect of tiotropium bromide combined with bronchoscopic large volume lung lavage on airway inflammation and lung function in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods 126 patients with pneumoconiosis combined with COPD admitted to Jingdezhen Disease Prevention and Control Center and Zhushan Xinchang Hospital from November 2019 to December 2020 were selected as the research subjects,and they were divided into two groups according to random number table method,with 63 cases in each group.The control group was treated with tiotropium bromide,and the observation group was treated with bronchoscopic large volume lung lavage on this basis.The airway inflammation,pulmonary function and incidence of adverse reactions were compared between the two groups.Results Before treatment,there was no significant difference in airway inflammation and pulmonary function between the two groups;After treatment,tumor necrosis factor in the observation group α(TNF-α),the levels of interleukin-8(IL-8)and interleukin-6(IL-6)in the control group were lower than those in the control group.The forced expiratory volume in the first second(FEV_(1)),peak expiratory flow rate(PEF),forced vital capacity(FVC)and maximum ventilation volume per minute(MVV)in the control group were higher than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in adverse reactions between the two groups.Conclusion Thiotronium bromide combined with bronchoscopic large volume lung lavage can reduce the airway inflammatory reaction in patients with pneumoconiosis and COPD,promote the improvement of pulmonary function,and have fewer adverse reactions,it is worthy of clinicial application.

关 键 词：尘肺病 慢性阻塞性肺疾病 噻托溴铵 经支气管镜大容量肺灌洗 气道炎症反应 肺功能 安全性 

分 类 号：R563[医药卫生—呼吸系统]