复方异丙托溴铵气雾剂糜蛋白酶雾化吸入治疗慢性阻塞性肺疾病患者疗效分析

目的 了解复方异丙托溴铵气雾剂、糜蛋白酶两种药物雾化吸入治疗稳定期慢性阻塞性肺疾病(COPD)患者肺功能改善情况.方法 150例COPD患者按COPD级别、年龄,综合考虑患者吸烟状况及其他影响肺功能损害的合并症、并发症等统一排序.依据患者的序列号/3的余数将患者分为3组:复方异丙托溴铵气雾剂组,糜蛋白酶组,对照组,每组均50例.对每位患者分别给予连续5d,每日上、下午各1次雾化吸入治疗,在首次雾化前及末次雾化后分别进行肺功能及血气分析检查,分析3组相关指标用力肺活量(FVC)、1秒钟用力呼气量(FEV1％)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2).结果雾化前后复方异丙托溴铵气雾剂组FVC[ (69±17)％、(74±15)％,t=-4.223,P＜0.01]、FEV1％ [(68±21)％、(71±20)％,t=-2.777,P ＜0.01]、PaO2[ (74 ±7)、(76 ±6)mm Hg,t=-11.201,P＜0.01]、PaCO2[ (40±3)、(39±2)mm Hg,t=3.888,P＜0.01]、SaO2[ (94.4±1.7)％、(94.9±1.1)％,t=- 4.452,P＜0.01],糜蛋白酶组FVC[ (66±13)％、(70±14)％,t=- 32.375,P=0.022]、FEV1％[ (63±13)％、(66±15)％,t=-2.229,P =0.030]、PaO2[(72±8)、(76±6)mm Hg,t=- 18.763,P＜0.01]、PaCO2[ (40±3)、(38 ±2)mm Hg,t =6.137,P ＜0.01]、SaO2[ (94.0±1.8)％、(95.0±1.3)％,t=-9.339,P＜0.01],差异均有统计学意义.结论 复方异丙托溴铵气雾剂及糜蛋白酶雾化吸入治疗均可明显改善COPD患者肺功能.

The efficacy of combivent and chymotrypsin inhalants in the patients with chronic obstructive pulmonary disease

Objective To investigate the effect of combivent and alpha-chymotrypsin inhalants on the improvement of lung function in patients with chronic obstructive pulmonary disease （COPD）. Methods One hundred and fifty patients with COPD were ranked in the order of COPD severity and a comprehensive evaluation of age, smoking status and other complications which may have effects on lung function. According to the rank of the patients, they were classified into three groups （combivent, alpha-chymotrypsin and control groups） according to remainder after their ranking numbers were divided by three. Each patient was given treatment two times （one in the morning and one in the afternoon） for 5 consecutive days. Lung function and blood gas were detected before first spray atomization and after last treatment. The parameters such as forced vital capacity （FVC）, Forced expiratory volume in one second （FEV1%）, arterial oxygen pressure （PaO2 ）, arterial carbon dioxide partial pressure （ PaCO2 ）, arterial oxygen saturation （SaO2 ） were compared. Results In the combivent group, the parameters before and after treatment were： FVC[（69 ±17）%, （74 ±15）%, t = -4.223, P〈0.01], FEV,% [（68± 21）%, （71 ±20）%, t= -2.777, P=0. 008], PAO2[（74 ±7）, （76 ±6）mm Hg, t= -11.201, P〈0.01], PACO2[（40±3）, （39±2）mm Hg, t=3.888, P〈0.01], SAO2[（94.4±1.7）%, （94.9±1.1）%, t= - 4. 452, P 〈0. 01 ]. in the alpha-chymotrypsin group, the parameters before and after treatment were： FVC[ （66 ± 13）%, （70±14）%, t = -32.375, P=0.022], FEV1%[（63 ＋±13）%, （66 ±15）%, t= -2.229, P= 0.030], PaO2[（72±8）, （76±6）mmHg, t=-18.763, P〈0.01], PACO2[（40±3）, （38±2）mmHg, t= 6. 137, P〈0.01], SAO2[（94.0±1.8）%, （95.0±1.3）%, t= -9.339, P〈0.001. Conclusion Combivent and alpha-chymotrypsin inhalants are both effective to improve the lung function of patients with COPD.