噻托溴铵对稳定期慢性阻塞性肺疾病患者血清细胞因子水平及肺功能的影响

目的探讨噻托溴铵对稳定期慢性阻塞性肺疾病(简称慢阻肺)患者肺功能的影响及气道炎症的改善作用。方法选择符合病例选择标准的患者81例,采用随机数字表法分为观察组40例和对照组41例,对照组口服茶碱缓释片,观察组给予噻托溴铵干粉剂,疗程均为16周。治疗前后观察第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、FEV1/预计值以及血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-12(IL-12)变化。结果两组患者治疗前FEV1/FVC、FEV1/预计值比较,差异无统计学意义(P0.05)。治疗16周时,两组患者FEV1/FVC、FEV1/预计值较本组治疗前均明显提高,差异有统计学意义(P0.05),且观察组提高幅度明显大于对照组(P0.05)。两组患者治疗前血清hs-CRP、TNF-α、IL-6及IL-12水平相似,差异无统计学意义(P0.05);治疗16周时,两组血清hs-CRP、TNF-α、IL-6及IL-12水平较本组治疗前均明显降低,差异有统计学意义(P0.05),且观察组降低幅度明显大于对照组(P0.05)。观察组患者不良反应发生率10.00%,对照组不良反应发生率14.63%,差异无统计学意义(P0.05)。结论噻托溴铵治疗善稳定期慢阻肺可显著改善患者肺功能、下调血清hs-CRP、TNF-α、IL-6及IL-12表达,抑制慢性炎性反应,延缓肺功能的减退。

Effect of tiotropium bromide on lung function and serum levels of cytokines in patients with COPD at stable stage

Objective To investigate the effect of tiotropium bromide on lung function and serum levels of cytokines in patients with COPD at stable stage.Methods A total of 81 eligible patients were selected and randomly divided into the observation group (40 patients)and the control group (41 patients).The control group orally took theophylline sustained-release tablets,while the observation group was given tiotropium bromide dry powder,both for 16 weeks.Changes in forced expiratory volume in one second (FEV1 ),forced vital capacity (FVC),FEV1 /FVC, and serum levels of hypersensitive C reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),and interleukin-12 (IL-12)were observed before and after the treatment.Results Before treatment,there was no significant difference in FEV1 ,FVC,and FEV1 /FVC between the two groups (P >0.05).16 weeks after treatment,the levels of FEV1 ,FVC,and FEV1 /FVC increased obviously in the two groups (P <0.05),and the
increase was more pronounced in the observation group than in the control group (P <0.05).There was no signifi-cant difference in hs-CRP,TNF-α,IL-6,and IL-12 between the two groups before treatment (P >0.05).16 weeks after treatment,the levels of hs-CRP,TNF-α,IL-6,and IL-12 decreased obviously in the two groups (P <0.05), and the decrease was more pronounced in the observation group than in the control group (P <0.05).The incidence of adverse reactions was 10.00% and 14.63% respectively in the observation group and the control group (P >0.05).Conclusion Tiotropium bromide can significantly improve their lung function,down-regulate the serum ex-pressions of hs-CRP,TNF-α,IL-6,and IL-12,inhibit chronic inflammatory reaction,and delay the impairment of lung function in the treatment of patients with COPD at stable stage.