舒利迭联合噻托溴铵对COPD合并支气管哮喘患者肺功能、免疫功能及气道阻力的影响

目的探讨舒利迭联合噻托溴铵对慢性阻塞性肺疾病(COPD)合并支气管哮喘患者肺功能、免疫功能及气道阻力的影响。方法选取2017年1月-2018年12月辽宁省某医院收治的102例COPD合并支气管哮喘患者为研究对象,采用随机数字表法分为研究组与对照组,每组51例。对照组患者给予噻托溴铵治疗,研究组患者给予舒利迭联合噻托溴铵治疗。比较2组患者治疗前及治疗2周时肺功能[第1秒用力呼气容积(FEV 1)、最大呼气流速(PEF)、肺活量(FVC)]、免疫功能[T淋巴细胞亚群(CD4^+,CD8^+,CD4^+/CD8^+)、自然杀伤细胞(NK细胞)水平]、气道阻力[气道总阻抗(Z5)、气道总黏性阻力(R5)、近端气道黏性阻力(R20)],比较2组患者治疗前及治疗3个月时健康状况调查简表(SF-36)评分。结果治疗前,2组患者FEV 1,PEF,FVC水平比较,差异均无统计学意义(P>0.05);治疗2周时,2组患者FEV 1,PEF,FVC水平均高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者CD4^+,CD8^+,CD4^+/CD8^+及NK细胞水平比较,差异均无统计学意义(P>0.05);治疗2周时,2组患者CD4^+,CD4^+/CD8^+,NK细胞水平均高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05);治疗2周时,2组患者CD8^+水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者Z5,R5,R20水平比较,差异均无统计学意义(P>0.05);治疗2周时,2组患者Z5,R5,R20水平均低于治疗前,且研究组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者SF-36中的MCS及PCS评分比较,差异均无统计学意义(P>0.05);治疗3个月时,2组患者SF-36中的MCS及PCS评分均高于治疗前,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论舒利迭联合噻托溴铵治疗COPD合并支气管哮喘效果良好,能够有效改善患者肺功能及免疫功能,降低气道阻力。

Effects of Seretide combined with tiotropium bromide on pulmonary function,immune function and airway resistance in patients with COPD complicated with bronchial asthma

Objective To explore the effects of Seretide combined with tiotropium bromide onpulmonary function,immune function and airway resistance in patients with chronic obstructive pulmonary disease(COPD)complicated with bronchial asthma.Methods A total of 102 patients with COPD and bronchial asthma who were treated in a hospital in Liaoning from January 2017 to December 2018 were selected for the study and were divided into study group and control group according to the random number table method,with 51 cases in each group.Control group was treated with tiotropium bromide,and study group was given Seretide combined with tiotropium bromide.Pulmonary function[forced expiratory volume in 1st second(FEV 1),peak expiratory flow rate(PEF),forced vital capacity(FVC)],immune function[T lymphocyte subset CD4^+,CD8^+,CD4^+/CD8^+,natural killer cells(NK cells)]and airway resistance[total airway impedance(Z5),total airway viscous resistance(R5),proximal airway viscous resistance(R20)]were compared between the two groups before treatment and 2 weeks of treatment.Quality of life[Short-form Quality of Life Scale(SF-36)]was compared between the two groupsbefore treatment and 3 months of treatment.Results After 2 weeks and 3 months of treatment,the FEV 1,PEF,FVC,CD4^+,CD4^+/CD8^+,NK cells and levels of MCS and PCS of SF-36 in the two groups were significantly higher than those before treatment,and the indexes in study group were significantly larger than those in control group at the same time period(all P<0.05).The levels of CD8^+,Z5,R5 and R20 in the two groups were significantly lower than those before treatment,and the indexes in study group were significantly smaller than those in control group at the same time period(all P<0.05).Conclusion Seretide combined with tiotropium bromide has good effects in the treatment of COPD with bronchial asthma,and it can effectively improve pulmonary function and immune function and reduce airway resistance.