沙美特罗替卡松联合噻托溴铵治疗稳定期老年COPD患者的临床研究  

Clinical trial of salmeterol and fluticasone propionate combined with tiotropium in treatment of elderly patients with stable COPD

作　　者：周霞 娄丽丽 杨柳[1] 程慧鑫 ZHOU Xia;LOU LI-li;YANG Liu;CHENG Hui-xin(Department of Geriatrics,Daqing Longnan Hospital,Daqing 163000,Heilongjiang Province,China)

机构地区：[1]大庆龙南医院老年病科,黑龙江大庆163000

出　　处：《中国临床药理学杂志》2024年第17期2459-2463,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的分析沙美特罗替卡松联合噻托溴铵治疗稳定期老年慢性阻塞性肺疾病(COPD)患者疗效及对血清降钙素原(PCT)、淀粉样蛋白A(SAA)和白蛋白与纤维蛋白原比值(AFR)水平的影响。方法将稳定期老年COPD患者分为对照组和试验组。对照组给予沙美特罗替卡松吸入粉雾剂治疗,每次1吸,bid;试验组在对照组治疗的基础上,给予噻托溴铵吸入粉雾剂治疗,每次1吸,qd,2组患者均治疗3个月。比较2组患者的临床疗效、肺功能[1s用力呼气容积(FEV1)、FEV1/用力肺活量(FEV1/FVC)、呼气峰流速(PEF)]、改良英国医学研究委员会呼吸问卷(mMRC)评分、COPD患者自我评估测试问卷(CAT)评分、血清PCT、SAA和AFR水平的差异,并进行安全性评价。结果试验组和对照组分别纳入52例和58例患者。治疗后,试验组和对照组的总有效率分别为90.38%(47例/52例)和75.86%(44例/58例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组和对照组的FEV1分别为(1.49±0.33)和(1.36±0.29)L,FEV1/FVC分别为(61.28±10.56)%和(57.41±10.03)%,PEF分别为(5.32±0.88)和(4.93±0.75)L·s-1,mMRC评分分别为(0.99±0.24)和(1.21±0.27)分,CAT评分分别为(11.58±3.02)和(14.26±3.71)分,PCT分别为(0.76±0.11)和(0.85±0.18)μg·L-1,SAA分别为(34.59±4.15)和(37.66±5.34)mg·L-1,AFR分别为(5.97±1.12)和(5.53±1.06),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.05)。试验组的药物不良反应主要有口干、便秘、头晕、恶心,对照组的药物不良反应主要有口干、便秘、头晕、恶心。试验组和对照组的总药物不良反应发生率分别为21.15%(11例/52例)和13.79%(8例/58例),在统计学上差异无统计学意义(P>0.05)。结论沙美特罗替卡松吸入粉雾剂联合噻托溴铵吸入粉雾剂能有效提升稳定期老年COPD患者的临床疗效,改善患者的肺功能,减轻机体炎症,促进患者病情好转,安全性较好。Objective To analyze the efficacy of salmeterol rotticasone combined with tiotropium bromide in the treatment of elderly patients with stable chronic obstructive pulmonary disease(COPD)and its influence on serum procalcitonin(PCT),serum amyloid A(SAA)and albumin-to-fibrinogen ratio(AFR)levels.Methods The elderly patients with stable COPD were divided into control group and treatment group.The control group was treated with salmeterol rotticasone inhalation powder(1 in halation each time,twice a day),while the treatment group was given tiotropium bromide inhaled powder aerosol treatment(1 inhalation each time once a day)on the basis of the control group.Patients in two groups were treated for 3 months.The clinical efficacy and differences in pulmonary function[forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),peak expiratory flow(PEF)],modified British Medical Research Council respiratory questionnaire(mMRC)score,COPD Assessment Test(CAT)score and serum PCT,SAA and AFR levels were compared;and the safety was evaluated.Results Fifty-two patients and fifty-eight patients were included in treatment group and control group,respectively.After treatment,the total effective rates in treatment group and control group were 90.38%(47 cases/52 cases)and 75.86%(44 cases/58 cases)(P<0.05).The FEV1 values in treatment group and control group were(1.49±0.33)and(1.36±0.29)L;the FEV1/FVC values were(61.28±10.56)%and(57.41±10.03)%;PEF values were(5.32±0.88)and(4.93±0.75)L·s-1;mMRC scores were(0.99±0.24)and(1.21±0.27)points;the CAT scores were(11.58±3.02)and(14.26±3.71)points;PCT levels were(0.76±0.11)and(0.85±0.18)μg·L-1;SAA levels were(34.59±4.15)and(37.66±5.34)mg·L-1;AFR levels were 5.97±1.12 and 5.53±1.06,respectively.Compared with the control group,the above indexes in the treatment group were statistically significant(all P<0.05).The main adverse drug reactions in treatment group were dry mouth,constipation and dizziness and nausea,and the main adverse drug reactions in contr

关 键 词：沙美特罗替卡松吸入粉雾剂 噻托溴铵吸入粉雾剂 慢性阻塞性肺疾病 稳定期 老年 疗效 炎症反应 

分 类 号：R974[医药卫生—药品]