噻托溴铵对老年慢性呼吸道疾病加重预防作用

目的分析噻托溴铵对老年慢性呼吸道疾病加重的预防作用,探讨其临床应用价值。方法选取2012年5月至2015年5月解放军11医院收治的180例老年慢性呼吸道疾病患者为研究对象,随机分为噻托溴铵组及舒利迭组,每组90例。两组患者分别在常规治疗的基础上加用噻托溴铵与舒利迭,比较治疗前后肺功能变化及急性加重次数。结果治疗后,两组患者用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC、动脉血氧分压(Pa O2)、均显著上升,动脉血二氧化碳分压(Pa CO2)均显著下降,噻托溴铵组变化更为明显,两组比较,差异有统计学意义(P<0.05)。两组患者治疗后,IL-6、TNF-α均显著降低,噻托溴铵组降低更为明显,两组比较,差异有统计学意义(P<0.05)。噻托溴铵组临床总有效率为91.1%,舒利迭组为81.1%,两组临床总有效率比较,差异无统计学意义(P>0.05)。噻托溴铵组不良反应发生率为6.7%,舒利迭组不良反应发生率为7.8%,两组不良反应发生率比较,差异无统计学意义(P>0.05)。噻托溴铵组治疗期间急性加重次数(1.19±0.58)次,舒利迭组为(4.17±2.06)次,噻托溴铵组治疗期间急性加重次数显著低于舒利迭组,差异有统计学意义(P<0.05)。结论噻托溴铵能够明显改善老年慢性呼吸道疾病患者肺功能,降低其炎性因子水平,具有良好的临床疗效,安全可靠,对预防慢性呼吸道疾病的加重具有积极意义。

Preventive effect of Tiotropium bromide on the elderly patients with chronic respiratory diseases

Objective To explore the preventive effect and clinical application value of tiotropium bromide on the elderly patients with chronic respiratory diseases. Methods A retrospective study was performed on 180 cases of elderly patients with chronic respiratory diseases received from May 2012 to May 2015 were randomly divided into Tiotropium bromide group and Seretide group,within 90 ca-ses in each group. Patients in each group received Tiotropium bromide combined Seretide. Clinical features such as the change of pul-monary function before and after treatment and the frequency of acute exacerbation were compared. Results FEV1,FEV1/FVC,PaO2 between two groups of patients after treatment were significantly increased,PaCO2 was significantly decreased,and the change of FVC were significantly different, the difference was statistically significant ( P <0. 05 ) . After treatment, the IL-6 and TNF-α of the two groups were lower,especially in the Tiotropium bromide group,and the difference was statistically significant(P<0. 05). In Tiotropium bromide group,the clinical total effective rate was 91. 1%,in Seretide group was 81. 1%. There was no stastistically different total ef-fective rate betweeen two groups(P>0. 05). In Tiotropium bromide group,the incidence of adverse reaction was 6. 7%,in Seretide group was 7. 8%,between the two groups,there was no statistically significant difference(P>0. 05). In Tiotropium bromide group,ex-acerbation number with (1. 19 ± 0. 58)times was significantly less than that in Seretide group with (4. 17 ± 2. 06) times(P<0. 05). Conclusion Tiotropium bromide can significantly improve lung function and reduce the level of inflammatory factors in elderly patients with chronic respiratory diseases. There are great clinical effect,reliable safety and positive prevention of chronic respiratory diseases.