慢性阻塞性肺疾病临床新型三联治疗药物研究现况与进展  

Current status and progress of novel clinical triple therapy drugs for chronic obstructive pulmonary disease

作　　者：胡涵硕 王卓[1,2] 刘晓东 HU Han-shuo;WANG Zhuo;LIU Xiao-dong(Department of Pharmacy,Shengjing Hospital of China Medical University,Shenyang LIAONING 110004,China;Department of the Second Clinical Pharmacy,School of Pharmacy,China Medical University,Shenyang LIAONING 110001,China)

机构地区：[1]中国医科大学附属盛京医院药学部,辽宁沈阳110004 [2]中国医科大学药学院第二临床药学教研室,辽宁沈阳110001

出　　处：《中国新药与临床杂志》2024年第2期127-132,共6页Chinese Journal of New Drugs and Clinical Remedies

基　　金：中国医科大学附属盛京医院2020盛京345人才计划(M0723)。

摘　　要：目前指南建议,对于在接受吸入性糖皮质激素(ICS)+长效肾上腺素β2受体激动药(LABA)或LABA+长效抗胆碱药(LAMA)双联治疗后仍出现急性加重的慢性阻塞性肺疾病(COPD)患者[血嗜酸性粒细胞计数(EOS)≥100个细胞·μL^(-1)],推荐使用ICS+LABA+LAMA三联疗法。多项研究结果显示,三联疗法可有效减少中重度COPD患者的急性加重次数,改善肺功能和生活质量,且安全性良好。在EOS≥300个细胞·μL^(-1)的患者中,三联疗法对急性加重风险的保护作用更加明显。与多吸入器三联疗法相比,单吸入器三联疗法在改善COPD患者第1秒用力呼气容积方面有显著优势,但两者在控制中重度急性加重率、降低圣乔治呼吸问卷得分、减少不良事件方面无显著差异,不同三联疗法治疗COPD的疗效和安全性值得进一步研究。Current guidelines recommend the use of a triple therapy regimen combining inhaled corticosteroids(ICS),long-actingβ2 adrenoceptor agonists(LABA),and long-acting muscarinic antagonists(LAMA)for patients with chronic obstructive pulmonary disease(COPD)who continue to experience acute exacerbations despite dual therapy with either ICS+LABA or LABA+LAMA,if the blood eosinophil count is 100 cells·μL^(-1).Multiple studies have shown that triple therapy effectively reduced the frequency of acute exacerbations in patients with moderate to severe COPD,improved lung function and quality of life,and demonstrated good safety.The protective effect of triple therapy against acute exacerbations was even more pronounced in patients with an eosinophil count of 300 cells·μL^(-1) or higher.Compared to the use of multiple inhalers for triple therapy,single-inhaler triple therapy showed significant advantages in improving the forced expiratory volume in one second in COPD patients.However,there were no significant differences between the two approaches in controlling the rate of moderate to severe acute exacerbations,reducing the scores on the St.George's Respiratory Questionnaire,or in the incidence of adverse events.The efficacy and safety of different triple therapy regimens in the treatment of COPD warrant further investigation.

关 键 词：肺疾病 慢性阻塞性 药物疗法 联合 糖皮质激素类 肾上腺素能β-2受体激动剂 胆碱能拮抗剂 

分 类 号：R974[医药卫生—药品]