罗氟司特联合布地奈德对支气管哮喘患者肺功能小气道参数的影响  

Effects and clinical predictive value of pulmonary function small airway parameters in patients with bronchial asthma receiving roflumilast combined with budesonide

作　　者：吴杨 Wu Yang(Department of Respiratory,Lanxi People′s Hospital,Jinhua,Zhejiang 321100,China)

机构地区：[1]兰溪市人民医院呼吸科,浙江金华321100

出　　处：《中国药物与临床》2025年第3期192-196,共5页Chinese Remedies & Clinics

摘　　要：目的分析罗氟司特联合布地奈德对支气管哮喘患者肺功能小气道参数的影响,并探讨肺功能小气道参数对支气管哮喘的预测价值。方法以2021年11月至2023年11月浙江省兰溪市人民医院收治的82例支气管哮喘患者为病例组,按照简单随机抽样法分为2组。对照组41例予以布地奈德雾化吸入治疗,试验组41例予以罗氟司特联合布地奈德雾化吸入治疗。比较2组的临床疗效,观察2组的症状改善时间,评价2组治疗前后肺功能小气道参数变化。另选取同期与兰溪市人民医院接受健康检查的80名志愿者作为健康组,采用受试者特征工作曲线(ROC)评价肺功能小气道参数对重度支气管哮喘的预测价值。结果试验组的治疗总有效率为95.1%,高于对照组的68.3%(P<0.05);试验组的咳嗽,呼吸困难,气促、胸闷,哮鸣音症状改善时间分别为(2.6±0.5)d、(3.8±0.6)d、(2.7±0.5)d、(3.6±0.9)d,较对照组的(3.5±0.6)d、(4.7±1.0)d、(3.9±0.8)d、(5.8±1.2)d缩短(P<0.05);治疗后试验组的1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、峰值呼气流量(PEF)占预计值百分比(FEV_(1)%pred、FVC%pred、PEF%pred)、FEV_(1)/FVC比值分别为(98±7)%、(98±4)%、(96±6)%、(90±7)%,均较对照组的(88±6)%、(94±5)%、(86±6)%、(80±9)%升高(P<0.05);ROC曲线显示,FEV_(1)%pred、FVC%pred、PEF%pred、FEV_(1)/FVC联合预测重度支气管哮喘的曲线下面积(AUC)为0.920,敏感度为92.68%,特异度为77.50%,联合预测效能优于各指标单独预测(P<0.05)。结论罗氟司特联合布地奈德对重度支气管哮喘患者的治疗效果显著,可有效改善患者的肺功能小气道参数,早期测定肺功能小气道参数可为重度支气管哮喘提供一定的预测价值。Objective To analyze the influence of roflumilast combined with budesonide on pulmonary function small airway parameters in patients with bronchial asthma,and to explore the predictive value of pulmonary function small airway parameters on bronchial asthma.Methods A total of 82 patients with bronchial asthma admitted to Lanxi People′s Hospital from November 2021 to November 2023 were divided into a control group and a treatment group,with 41 cases in each group.The control group were treated with budesonide atomization inhalation,and the treatment group received roflumilast combined with budesonide atomization inhalation.The clinical efficacy of the two groups was compared,the symptom improvement time was observed,and the changes of pulmonary function small airway parameters before and after treatment were evaluated.In addition,a total of 80 volunteers who received health examination in the hospital during the same period were included in the healthy group.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of small airway parameters of pulmonary function on severe bronchial asthma.Results The total effective rate of the experimental group was 95.1%,which was higher than the 68.3%of the control group(P<0.05).The improvement time of cough,dyspnea,shortness of breath,chest tightness,and wheezing symptoms in the experimental group were[(2.6±0.5)days,(3.8±0.6)days,(2.7±0.5)days,and(3.6±0.9)days]were shorter than the control group[(3.5±0.6)days,(4.7±1.0)days,(3.9±0.8)days,and(5.8±1.2)days].After treatment,the forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),peak expiratory flow(PEF)as a percentage of the predicted values(FEV_(1)%pred,FVC%pred,PEF%pred),and FEV_(1)/FVC ratio in the experimental group[(98±7)%,(98±4)%,(96±6)%,and(90±7)%]were significantly higher than those in the control group[(88±6)%,(94±5)%,(86±6)%,and(80±9)%](P<0.05).ROC curve manifested that the area under the curve(AUC),sensitivity and specificity of combination of FEV_(1)

关 键 词：哮喘 罗氟司特 布地奈德 治疗结果 

分 类 号：R562.25[医药卫生—呼吸系统]