吸入噻托溴铵联合比索洛尔对 COPD 患者心肺功能的影响

目的：探讨吸入噻托溴铵联合比索洛尔对慢性阻塞性肺疾病（ COPD）稳定期患者呼吸肌功能相关指标、运动耐力及心肺功能的影响。方法回顾性分析我院89例 COPD 稳定期患者的临床资料，根据治疗方案分为对照组和观察组，对照组40例在基础治疗上吸入噻托溴铵治疗，观察组49例在对照组基础上给予比索洛尔口服治疗，检测两组治疗前后心肺功能、呼吸肌相关指标、运动耐力及用药安全性；随访12个月，记录急性发作次数、心力衰竭发生率及死亡率。结果两组患者治疗后心肺功能、运动耐力和呼吸肌功能相关指标均较治疗前明显改善（ P ﹤0.05）。观察组治疗后左心室舒张末期内径、脑钠肽、吸气时间比例和急性期发作次数显著低于对照组（ P ﹤0.05）；而左心室射血分数、最大吸气压力、最大呼气压力、呼吸浅快指数和6 min 步行距离显著高于对照组（P ﹤0.05）。两组不良反应发生率、随访心力衰竭发生率和死亡率比较差异无统计学意义（ P ﹥0.05）。结论吸入噻托溴铵联合比索洛尔用于COPD 稳定期治疗能够改善心肺功能，提高呼吸肌耐力和运动耐力。

Effect of Inhalation of Tiotropium Bromide Combined with Bisoprolol on Cardiopulmonary Function of Patients with COPD

Objective To investigate effects of inhalation of Tiotropium Bromide combined with Bisoprolol on re-lated indexes of respiratory muscle,exercise tolerance and cardiopulmonary function of patients with chronic obstructive pulmonary disease(COPD)in stable phase. Methods Clinical data of 89 COPD patients in stable phase admitted was retrospectively analyzed. The patients were divided into control group(n = 40)and observation group(n = 49)according to therapeutic methods. Control group was treated with inhalation of Tiotropium Bromide based on basic therapy,while observation group was added with Bisoprolol orally based on the treatment of control group. The cardiopulmonary func-tion,related indexes of respiratory muscle,exercise tolerance and medication safety in two groups were detected before and after treatment;times of acute attack,incidence rate of heart failure and mortality rate were recorded and followed up for 12 months. Results The cardiopulmonary function,exercise tolerance and related indexes of respiratory muscle after treatment were significantly improved compared with those before treatment in two groups(P ﹤ 0. 05). After treatment, values of left ventricular end diastolic dimension(LVEDD),brain natriuretic peptide(BNP),ratio of inspiratory dura-tion and times of acute attack in observation group were significantly lower than those in control group,while left ventricu-lar ejection fraction(LVEF)was higher than that of the control group(P ﹤ 0. 05);values of left ventricular ejection frac-tion,maximum inspiratory pressure(MIP),maximal expiratory pressure( MEP),rapid shallow breathing index and 6 min walking distance in observation group were significantly higher than those in control group while inspiratory time ratio was lower than that of the control group(P ﹤ 0. 05). There were no significant differences in incidences rates of adverse reaction,heart failure and mortality in two groups(P ﹥ 0. 05). Conclusion Inhalation of Tiotropium Bromide combined with Bisoprolol can improve cardiopulmonary function,respiratory muscle and exercise tolerance of COPD patients in sta-ble phase.