噻托溴铵联合沙美特罗吸入对中重度POCD稳定期的治疗研究

目的：探讨噻托溴铵联合沙美特罗吸入对稳定期中重度慢性阻塞肺疾病（COPD）治疗作用。方法：选取本院收治的稳定期中重度COPD患者120例,随机分为A、B、C 3组,A组采用噻托溴铵吸入治疗,B组采用沙美特罗/替卡松吸入治疗,C组采用噻托溴铵联合沙美特罗/替卡松吸入治疗,对比3组治疗4、12周后BODE指数（B为体重指数,O为气流阻塞,D为呼吸困难,E为运动能力）评分、血气指标及静脉血中基质金属蛋白酶-9（MMP-9）水平变化。结果 ：3组治疗后BODE指数较治疗前下降,差异有统计学意义（P〈0.05）;C组治疗后BODE指数改善较A、B组更为明显,差异有统计学意义（P〈0.05）;3组治疗后血清MMP-9水平较治疗前明显下降,差异有统计学意义（P〈0.05）;C组治疗后血清MMP-9水平下降较A、B组更为明显,差异有统计学意义（P〈0.05）。结论：噻托溴铵铁联合沙美特罗吸入治疗稳定期中重度COPD,可有效延缓肺功能的进行性下降,降低患者BODE指数及血清MMP-9水平,对改善COPD患者预后有重要意义。

Therapeutic effect of Tiotropium bromide combined Salmeterol for inhalation in stabilization stage of moderately severe POCD

Objective： To explore the treatment effects of Tiotropium bromide combining with Salmeterol for inhalation in stabilization stage of moderately severe chronic obstructive pulmonary disease （COPD）. Methods： A total of 120 patients with moderately severe COPD were randomly divided into groups A, B and C, group A were treated with thiamethoxam bro- mide inhalation therapy, group B were treated with Salmeterol Xinafoate and Fluticasone Propionate inhalation therapy, group C were treated with thiamethoxam bromide combined salmeterol inhalation therapy. BODE index score, blood gas index and MMP-9 level changes in venous blood were compared between the three groups at 4 and 12 weeks after treatment. Results： BODE index decreased significantly after treatment （P〈0.05） in all groups; BODE index in group C was improved more sig- nificantly than that in groups A and B （P〈0.05） ; there was no statistical difference in BODE index between groups A and B （P〉0.05） ;serum levels of MMP-9 in three groups decreased significantly after treatment （P〈0.05）, MMP-9 in group C de- creased more significantly than that in groups A and B （P〈0.05） ;there was no statistical difference of MMP-9 between groups A and B （P〉0.05）. Conclusion： Tiotropium bromide combining with Salmeterol for inhalation can effectively slow the pro-gressive decline of lung function in stabilization stage of moderately severe POCD, reduce the BODE index and serum level of MMP-9, and has important significance for improving the prognosis of patients with COPD.