噻托溴铵治疗COPD稳定期患者的疗效及其对血清MMP-9和IL-8的影响

目的 观察噻托溴铵治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效,并探讨其对血清基质金属蛋白酶9 (MMP-9)和白细胞介素-8 (IL-8)水平的影响.方法 选择本院2014年1月至2015年3月收治的COPD稳定期患者136例,随机分为对照组和观察组各68例.对照组进行常规治疗,观察组在对照组治疗的基础上应用噻托溴铵吸入治疗,1次/d,2个月为一个疗程.评估两组患者治疗前后的最大呼气流量(PEF)、一秒钟用力呼气量预计值(FEV1%)、最大肺活量(FVC)等肺功能指标;应用呼吸困难指数(mMRC)评估患者呼吸状况;检测血清中基质金属蛋白酶9 (MMP-9)和白细胞介素-8 (IL-8)浓度.结果 观察组治疗后的PEF、FEV1%和FVC结果分别为(2.60±0.49) L、(64.68±1.57)%和(1.86±0.60) L,对照组为(2.04±0.51) L、(60.44±1.30)%和(1.75±0.51) L,观察组高于对照组,且两组治疗后均高于治疗前,差异均有统计学意义(P<0.05);观察组治疗后的mMRC评分为(1.80±0.22)分,对照组治疗后为(1.98±0.29)分,观察组低于对照组,且两组治疗后mMRC评分均低于治疗前,差异均有统计学意义(P<0.05);观察组治疗后的MMP-9和IL-8分别为(398.75±57.46)μg/L和(7.12±1.16)μg/L,均低于对照组治疗后的(529.64±61.23)μg/L和(9.83±1.05)μg/L,且两组IL-8和MMP-9治疗后均低于治疗前,差异均有统计学意义(P<0.05);观察组的总有效率为97.06%,明显高于对照组的88.24%,差异有统计学意义(P<0.05).结论 噻托溴铵对COPD稳定期患者具有较好的临床疗效,能够显著改善肺功能,降低MMP-9和IL-8水平,对稳定肺功能具有显著作用.

Clinical effect of tiotropium bromide in patients with chronic obstructive pulmonary disease at stable stage and its effects on serum MMP-9 and IL-8

Objective To observe the clinical effect of tiotropium bromide in patients with chronic obstructive pulmonary disease (COPD) at stable stage, and to explore its effect on serum matrix metalloproteinase-9 (MMP-9) and interleukin-8 (IL-8). Methods A total of 136 COPD patients at stable stage were selected in the hospital from January 2014 to March 2015, which were randomly divided into the control group and the observation group, with 68 cases in each group. The control group was given conventional treatment, and the observation group received treatment of tiotropium bromide inhalation based on the control group, 1 time/d, for 2 months as a treatment course. Pulmonary function indexes before and after treatment, including peak expiratory flow (PEF), forced expiratory volume in one second the expected value (FEV1%) and forced vital capacity (FVC), were evaluated. Dyspnea index (mMRC) was applied to assess the re-spiratory condition of patients. The serum levels of MMP-9 and IL-8 were detected. Results PEF, FEV1%and FVC were (2.60±0.49) L, (64.68±1.57)%and (1.86±0.60) L in the observation group after treatment, significantly higher than (2.04±0.51) L, (60.44±1.30)%and (1.75±0.51) L in the control group, and the PEF, FEV1%and FVC after treatment in the two groups were significantly higher than those before treatment (P<0.05). mMRC score after treatment was (1.80 ± 0.22) in the observation group, significantly lower than (1.98 ± 0.29) in the control group (P<0.05), and mMRC scores of the two groups after treatment were significantly lower than those before treatment (P<0.05). The levels of MMP-9 and IL-8 after treatment were (398.75 ± 57.46) g/L and (7.12 ± 1.16) g/L in the observation group, significantly lower than (529.64 ± 61.23) g/L and (9.83 ± 1.05) g/L in the control group, and the IL-8 and MMP-9 levels of the two groups after treatment were significantly lower than those before treatment (P<0.05). The total effective rate was 97.06%in the observation group, significantly higher than 88.24%in the control group (P<0.05). Conclusion Tiotropium bro-mide has better clinical effect on COPD patients at stable stage, which can significantly improve lung function, reduce MMP-9 and IL-8 levels, and has obvious effect on the stability of pulmonary function.