ICS+LABA+LAMA联合治疗哮喘-慢性阻塞性肺疾病重叠患者的临床研究  

Clinical study of ICS+LABA+LAMA in the treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome

作　　者：叶小建 翁建光 刘小斌 Ye Xiao-jian;Weng Jian-guang;Liu Xiao-bin(Department of Respiratory Medicine,The People's Hospital of Ningdu,Ganzhou 342800,Jiangxi,China)

机构地区：[1]宁都县人民医院呼吸内科,江西赣州342800

出　　处：《四川生理科学杂志》2025年第3期499-501,共3页

基　　金：赣州市科技计划项目(编号:GZ2024ZSF683)。

摘　　要：目的:探讨吸入糖皮质激素(ICS)+β2受体激动剂(LABA)+吸入性长效毒蕈碱拮抗剂(LAMA)联合治疗哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者的临床研究。方法:选取2023年1月-2024年5月宁都县人民医院接诊的66名ACOS患者,按照随机掷硬币法分为常规组(33例,采取ICS联合LABA治疗)和研究组(33例,在常规组基础上给予LAMA治疗),连续治疗20d,分析两组患者的疾病评估[慢性阻塞性肺疾病自我评估(CAT)、哮喘控制测试(ACT)]状况、肺功能指标[第一秒最大用力呼气容量(FEV1)、呼气流量峰值(PFE)、FEV1/用力肺活量(FVC)比值]水平、免疫功能指标[CD3+T细胞、CD4+T细胞、CD4+T/CD8+T细胞比值]水平和不良反应。结果:治疗20d后,两组ACOS患者的CAT评分低于同组治疗前,ACT评分高于同组治疗前,且相较于常规组,研究组CAT评分较低,ACT评分较高(P<0.05);对比同组治疗前,两组ACOS患者治疗20 d后的FEV1、FEV1/FVC、PFE指标水平均升高,且研究组高于常规组(P<0.05);两组ACOS患者治疗20 d后的CD3+T、CD4+T和CD4+T/CD8+T细胞水平均高于同组治疗前,且研究组高于常规组(P<0.05);对比ACOS患者的不良反应总发生率,研究组与常规组差异较小(P>0.05)。结论:ICS+LABA+LAMA联合应用于ACOS患者中,能有效改善患者的疾病状况,显著调节肺功能和免疫功能且安全性较好。Objective:To investigate the clinical study of combination of inhaled corticosteroid(ICS)+β2 receptor agonist(LABA)+inhaled long-acting muscarinic antagonist(LAMA)in the treatment of patients with asthma-chronic obstructive pulmonary disease overlap syndrome(ACOS).Methods:66 ACOS patients in The People’s Hospital of Ningdu were selected from January 2023 to May 2024,and were divided into conventional group(33 cases,ICS combined with LABA)and study group(33 cases,LAMA on the basis of conventional group)according to the random coin tossing method.After 20 days of continuous treatment,the disease assessment[chronic obstructive pulmonary disease assessment test(CAT),asthma control test(ACT)],lung function indicators[maximum forced expiratory volume in the first second(FEV1),peak expiratory flow(PFE),FEV1/forced vital capacity(FVC)ratio],immune function indicators[CD3+T cell,CD4+T cell,CD4+T/CD8+T cell ratio]and adverse reactions were analyzed in the two groups.Results:After 20 days of treatment,the CAT score in the two groups of ACOS patients was lower while the ACT score was higher than that before treatment,and compared with conventional group,the CAT score in study group was lower while the ACT score was higher(P<0.05).Compared with the same group before treatment,the FEV1,FEV1/FVC and PFE in both groups were increased after 20 days of treatment,and the indicators in study group were higher than those in conventional group(P<0.05).The levels of CD3+T,CD4+T and CD4+T/CD8+T in the two groups after 20 days of treatment were higher than those before treatment,and the levels were higher in study group than those in conventional group(P<0.05).Comparison of total incidence rate of adverse reactions in ACOS patients revealed a small difference between study group and conventional group(P>0.05).Conclusion:The combination of ICS+LABA+LAMA in patients with ACOS can effectively improve the disease status,and significantly regulate the lung function and immune function,and it has good safety.

关 键 词：吸入糖皮质激素 Β2受体激动剂 吸入性长效毒蕈碱拮抗剂 哮喘-慢性阻塞性肺疾病重叠综合征。 

分 类 号：R56[医药卫生—呼吸系统]