布地奈德福莫特罗联合噻托溴铵对老年AECOPD患者的影响研究  

Study on the effect of budesonide/formoterol combined with tiotropium bromide on elderly patients with AECOPD

作　　者：杨斯媛 YANG Si-yuan(Yicheng District People's Hospital,Zaozhuang 277300,China)

机构地区：[1]枣庄市峄城区人民医院,277300

出　　处：《中国实用医药》2025年第7期8-13,共6页China Practical Medicine

摘　　要：目的探讨在老年慢性阻塞性肺疾病急性加重期(AECOPD)治疗中采取布地奈德福莫特罗联合噻托溴铵的效果。方法选取62例老年AECOPD患者,采用随机数字表法分为对照组(n=31,采用布地奈德福莫特罗治疗)与研究组(n=31,在对照组用药的基础上联合噻托溴铵治疗)。对比两组治疗效果,治疗前与治疗3个月后的血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]及运动耐力[6 min步行距离(6MWD)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平及生活质量[生活质量综合评定问卷-74(GQOLI-74)]评分,不良反应发生率。结果研究组治疗总有效率96.77%较对照组的74.19%高(P<0.05)。治疗3个月后,研究组PaO_(2)(70.61±4.51)mm Hg(1 mm Hg=0.133kPa)较对照组的(61.22±4.23)mmHg高,PaCO_(2)(46.53±2.42)mmHg较对照组的(54.12±2.63)mmHg低(P<0.05)。治疗3个月后,研究组FEV1(3.42±0.57)L、FVC(3.67±0.24)L、FEV1/FVC(74.74±5.34)%较对照组的(2.33±0.63)L、(3.15±0.43)L、(68.21±4.12)%高,6MWD(377.52±9.63)m较对照组的(298.52±8.15)m长(P<0.05)。治疗3个月后,研究组IL-6(2.66±0.67)ng/L、TNF-α(7.67±1.13)ng/L、CRP(11.54±1.16)mg/L较对照组的(4.16±1.04)ng/L、(12.32±1.26)ng/L、(17.85±1.34)mg/L低(P<0.05)。治疗3个月后,研究组躯体功能评分(83.31±4.48)分、心理功能评分(84.21±3.45)分、物质功能评分(85.16±3.81)分、社会功能评分(85.46±4.04)分较对照组的(77.64±4.51)、(78.52±3.41)、(80.55±3.43)、(79.88±4.12)分高(P<0.05)。研究组不良反应发生率3.23%较对照组的22.58%低(P<0.05)。结论在老年AECOPD治疗中采取布地奈德福莫特罗联合噻托溴铵疗效显著,可消除局部炎症反应,改善其肺功能与运动耐力,提高生活质量,安全性较高。Objective To explore the effect of budesonide/formoterol combined with tiotropium bromide on elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods 62 elderly patients with AECOPD were divided into control group(n=31,budesonide/formoterol)and the study group(n=31,tiotropium bromide in addition to the treatment of the control group)using a random number table method.Both groups were compared in terms of treatment efficacy,blood gas indicators[partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2))],lung function indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC]and exercise endurance[6-min walking distance(6MWD)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]levels,quality of life[Generic Quality of Life Inventory-74(GQOLI-74)]scores,and incidence of adverse reactions.Results The total effective rate of 96.77%in the study group was higher than 74.19%in the control group(P<0.05).After 3 months of treatment,the study group had a higher PaO_(2) of(70.61±4.51)mm Hg(1 mm Hg=0.133 kPa)than(61.22±4.23)mm Hg in the control group,and a lower PaCO_(2) of(46.53±2.42)mm Hg than(54.12±2.63)mm Hg in the control group(P<0.05).After 3 months of treatment,the study group had FEV1 of(3.42±0.57)L,FVC of(3.67±0.24)L and FEV1/FVC of(74.74±5.34)%,which were higher than(2.33±0.63)L,(3.15±0.43)L and(68.21±4.12)%in the control group;the study group had a longer 6MWD of(377.52±9.63)m than(298.52±8.15)m in the control group(P<0.05).After 3 months of treatment,the study group had IL-6 of(2.66±0.67)ng/L,TNF-αof(7.67±1.13)ng/L,CRP of(11.54±1.16)mg/L,TNF-αof(7.67±1.13)ng/L,and CRP of(11.54±1.16)mg/L,which were lower than(4.16±1.04)ng/L,(12.32±1.26)ng/L,and(17.85±1.34)mg/L in the control group(P<0.05).After 3 months of treatment,the physical function score of the study group was(83.31±4.48)points,the psychological function score

关 键 词：老年慢性阻塞性肺疾病急性加重期 布地奈德福莫特罗 噻托溴铵 肺功能 运动耐力 

分 类 号：R563[医药卫生—呼吸系统]