沙美特罗替卡松联合噻托溴铵吸入治疗矽肺并发COPD的临床效果  

Clinical efficacy of salmeterol xinafoate and fluticasone propionate combined with tiotropium bromide inhalation in treating silicosis complicated by COPD

作　　者：赵鹏林 赵锐艳 马丽萍 欧阳波 谢方方 ZHAO Penglin;ZHAO Ruiyan;MA Liping;OUYANG Bo;XIE Fangfang(Respiratory and Critical Care Medicine,Jiugang Hospital,Gansu Province,Jiayuguan 735100,China)

机构地区：[1]酒钢医院呼吸与危重症医学科,甘肃省嘉峪关市735100

出　　处：《临床合理用药杂志》2024年第17期14-17,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察沙美特罗替卡松联合噻托溴铵吸入治疗矽肺并发慢性阻塞性肺疾病(COPD)的临床效果。方法选取2020年7月—2022年11月酒钢医院收治的矽肺并发COPD稳定期确诊患者60例,采用随机数字表法分为观察组和对照组,各30例。在常规治疗基础上,对照组患者予噻托溴铵吸入粉雾剂治疗,观察组在对照组基础上联合沙美特罗替卡松吸入粉雾剂治疗,2组均治疗3个月。比较2组临床疗效,治疗前后的肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC]、血气指标[动脉血二氧化碳分压(PaCO_(2))、氧合指数(OI)、动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))]、6 min步行距离(6MWD)、生活质量评分以及不良反应。结果观察组患者治疗总有效率为93.33%,高于对照组的66.67%(χ^(2)=6.667,P=0.010);治疗3个月后,2组FVC、FEV_(1)、FEV_(1)/FVC均较治疗前增加,且观察组大于对照组(P<0.05或P<0.01);2组OI、PaO_(2)、SaO_(2)均较治疗前升高,PaCO_(2)降低,且观察组升高或降低的幅度大于对照组(P均<0.01);2组6MWD和生活质量评分均较治疗前延长/降低,且观察组改善幅度大于对照组(P均<0.01);观察组与对照组不良反应总发生率(13.33%vs.6.67%)比较差异无统计学意义(χ^(2)=0.185,P=0.667)。结论沙美特罗替卡松联合噻托溴铵吸入治疗矽肺并发COPD的临床效果显著,可有效改善患者肺功能,提升运动耐力及生活质量,且安全性较高。Objective To observe the clinical efficacy of salmeterol xinafoate and fluticasone propionate combined with tiotropium bromide administered via inhalation in the treatment of silicosis complicated by chronic obstructive pulmonary disease(COPD).Methods From July 2020 to November 2022,60 confirmed patients diagnosed with silicosis complicated by stable COPD were selected from Jiugang Hospital.They were randomly divided into observation group and control group,with 30 cases in each.On the basis of conventional treatment,patients in the control group were treated with Tiotropium Bromide Powder For Inhalation,while patients in the observation group received combined treatment with Salmeterol Xinafoate and Fluticasone Propionate Powder for Inhalation in addition to the treatment received by the control group.Both groups were treated for 3 months.Compare the clinical efficacy between the two groups,as well as changes in pulmonary function(FVC,FEV_(1),FEV_(1)/FVC),blood gas indicators(PaCO_(2),OI,PaO_(2),SaO_(2)),6-minute walk distance(6MWD),quality of life scores before and after treatment,and adverse reactions.Results The total effective rate of treatment in the observation group was 93.33%,which was higher than that in the control group(66.67%)(χ^(2)=6.667,P=0.010).After 3 months of treatment,both groups showed increases in FVC,FEV_(1),and FEV_(1)/FVC compared to before treatment,with greater improvements observed in the observation group than in the control group(P<0.05 or P<0.01).OI,PaO_(2),and SaO_(2) levels increased,while PaCO_(2) decreased compared to before treatment in both groups,with greater changes observed in the observation group(All P<0.01).6MWD and quality of life scores in both groups were prolonged/decreased compared to before treatment,with greater improvements observed in the observation group than in the control group(All P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(13.33% vs.6.67%,χ^(2)=0

关 键 词：矽肺 慢性阻塞性肺疾病 沙美特罗替卡松 噻托溴铵 肺功能 血气指标 

分 类 号：R563.9[医药卫生—呼吸系统] R135.2[医药卫生—内科学]