探讨异丙托溴铵联合特布他林治疗老年慢性阻塞性肺疾病

目的：探讨异丙托溴铵和特布他林联合应用对老年慢性阻塞性肺疾病患者的临床疗效、调节性T细胞、肺功能改善进行分析性比较研究。方法将2010～2013年该院收治的100例老年慢性阻塞性肺疾病患者随机分为两组，特布他林组50例，联合组50例。治疗前后监测临床疗效、肺功能和血气分析变化。并采用酶联免疫吸附试验检测各组受试者血清细胞因子肿瘤坏死因子‐α（TNF‐α）、白细胞介素‐8（IL‐8）变化。结果94例完成试验，两组有效率分别是87．67％、66．76％，联合组优于对照组（P＜0．05）。治疗后，两组患者血氧分压，第1秒钟用力呼气容积、用力肺活量均较治疗前升高，二氧化碳分压较治疗前降低，组内比较差异均有统计学意义（P＜0．05），且联合组优于特布他林组（P＜0．05）。血清细胞因子TNF‐α、IL‐8水平与治疗前相比，水平明显下降，组内治疗前后比较，差异有统计学意义（P＜0．05）。两组比较发现，联合组血清细胞因子TNF‐α、IL‐8水平明显下降，下降幅度大于特布他林组（P＜0．05）。结论异丙托溴铵和特布他林可以提高临床疗效，增强肺功能，改善血清细胞因子指标，治疗效果更优。

Effects of Ipratropium bromide combined terbutaILne on elderly with chronic obstructive pulmonary disease

Objective To explore the effect of the combined therapy of Ipratropium bromide with terbutaILne on lung function and serum cytokines in elderly patients with chronic obstructive pulmonary disease .Methods A to‐tal of 100 elderly chronic obstructive pulmonary patients were randomly divided into terbutaILne group and combined group ,50 patients in each group .The cILnical efficacy after treatment ,changes in lung function and blood gas analysis were compared between the two groups .Serum cytokines TNF‐α,IL‐8 levels were tested by Enzyme‐ILnked immu‐nosorbent assays .Results A total of 94 patients completed the experiment .The efficiency of the two groups were 87 .67% and 66 .76% ,the combined group was significant higher than the control group （P〈 0 .05） .After treat‐ment ,PaO2 ,FVC ,FEV1 of the two groups were all higher than those before treatment ,PaCO2 was lower than that before treatment ,differences were statistically significant （P〈0 .05） ,and the combined group were better than the terbutaILne group （P〈0 .05） .Serum cytokines TNF‐α,IL‐8 levels were significantly decreased after treatment（P〈0 .05） .The serum cytokines TNF‐α,IL‐8 levels of the combined group decreased significantly larger than that of the terbutaILne group （P〈0 .05） .Conclusion Ipratropium bromide and terbutaILne could improve cILnical outcomes , enhance lung function ,improve serum cytokines indicators ,and combined treatment is better .