噻托溴铵联合布地奈德福莫特罗治疗COPD的临床疗效及对COX-2、PLA2、MMP-9水平的影响  

Clinical Efficacy of Tiotropium Bromide Combined with Budesonide Formoterol in Treatment of COPD and Its Effect on COX-2,PLA2 and MMP-9 Levels

作　　者：梁超 简阅 肖伟 谢璟 LIANG Chao;JIAN Yue;XIAO Wei;XIE Jing(Department of Respiratory and Critical Care Medicine,Yibin First People′s Hospital,Yibin 644000,China;Department of General Medicine,Yibin First People′s Hospital,Yibin 644000,China;Department of Respiratory Medicine,Yibin Sixth People′s Hospital,Yibin 644000,China)

机构地区：[1]宜宾市第一人民医院呼吸与危重症医学科,四川宜宾644000 [2]宜宾市第一人民医院全科,四川宜宾644000 [3]宜宾市第六人民医院呼吸内科,四川宜宾644000

出　　处：《医学综述》2022年第21期4348-4353,共6页Medical Recapitulate

基　　金：宜宾市卫生健康委员会科研课题(2020YW40)。

摘　　要：目的分析噻托溴铵联合布地奈德福莫特罗治疗慢性阻塞性肺疾病(COPD)的临床疗效及对环加氧酶2(COX-2)、磷脂酶A2(PLA2)、基质金属蛋白酶9(MMP-9)水平的影响。方法选取2020年5—6月宜宾市第一人民医院收治的136例COPD患者作为研究对象,按照治疗方法不同分为研究组(68例)和对照组(68例)。两组患者均进行化痰、止咳、抗感染、营养支持、加强免疫力等常规治疗,对照组在常规治疗基础上单纯行布地奈德福莫特罗治疗,每次1吸,每日1次;研究组在常规治疗基础上联合噻托溴铵(每次1粒,每日1次)与布地奈德福莫特罗(同对照组)治疗。两组均连续治疗8周。比较两组患者的临床疗效,治疗前后6 min步行距离(6MWD)、改良英国医学研究委员会呼吸困难量表(mMRC)评分、第一秒用力呼气量(FEV_(1))、FEV_(1)/用力肺活量(FVC)、COX-2、PLA2、MMP-9水平变化。结果研究组总有效率高于对照组[86.77%(59/68)比57.35%(39/68)](χ^(2)=14.608,P<0.001)。6MWD、mMRC评分组间和时点间的主效应差异有统计学意义(P<0.01),且组间和时点间存在交互作用(P<0.01),治疗后,研究组6MWD明显长于对照组,mMRC评分明显低于对照组(P<0.05)。FEV_(1)、FEV_(1)/FVC组间和时点间的主效应差异有统计学意义(P<0.05或P<0.01),且组间和时点间存在交互作用(P<0.01),治疗后,研究组FEV_(1)、FEV_(1)/FVC明显高于对照组(P<0.05)。COX-2、PLA2、MMP-9组间和时点间的主效应差异有统计学意义(P<0.05或P<0.01),且组间和时点间存在交互作用(P<0.05或P<0.01),治疗后,研究组COX-2、PLA2、MMP-9明显低于对照组(P<0.05)。结论噻托溴铵联合布地奈德福莫特罗治疗COPD的临床疗效显著,可改善患者肺功能,降低COX-2、PLA2、MMP-9水平。Objective To analyze the clinical efficacy of tiotropium bromide combined with budesonide formoterol in the treatment of chronic obstructive pulmonary disease(COPD)and its effect on cycloxygenase-2(COX-2),phospholipase A2(PLA2)and matrix metalloprotein-9(MMP-9)levels.Methods A total of 136 COPD patients admitted to Yibin First People′s Hospital from May to Jun.2020 were included,and were divided into a study group(68 cases)and a control group(68 cases)according to different treatment methods.The patients in both groups received basic treatment such as reducing sputum,relieving cough,anti-infection,nutritional support and strengthening immunity.The control group was treated with budesonide and formoterol alone on the basis of the basic treatment,1 inhalation per time,once a day.The study group was treated with tiotropium bromide(1 tablet per time,once a day)and budesonide formoterol(the same as the control group)on the basis of the basic treatment.Both groups were treated for 8 weeks continuously.Clinical efficacy,6 min walking distance(6MWD),modified Medical Research Council scale(mMRC),forced expiratory volume in first second(FEV_(1)),FEV_(1)/forced vital capacity(FVC),COX-2,PLA2 and MMP-9 levels before and after treatment of the two groups were compared.Results The total effective rate of the study group was higher than that of the control group[86.77%(59/68)vs 57.35%(39/68)](χ^(2)=14.608,P<0.001).There were statistically significant differences in the main effects of 6MWD and mMRC between groups and time points(P<0.01),and there were interactions between groups and time points(P<0.01).After treatment,6MWD in the study group was significantly longer than that in the control group,and mMRC score was significantly lower than that in the control group(P<0.05).The main effects of FEV_(1) and FEV_(1)/FVC were significantly different between groups and time points(P<0.05 or P<0.01),and there were interactions between groups and time points(P<0.01).After treatment,FEV_(1) and FEV_(1)/FVC in the study group were sig

关 键 词：慢性阻塞性肺疾病 噻托溴铵 布地奈德福莫特罗 环加氧酶2 磷脂酶A2 基质金属蛋白酶9 

分 类 号：R563[医药卫生—呼吸系统]