强化药物方案对COPD患者肺功能及炎症因子的影响

目的研究强化药物方案对慢性阻塞性肺疾病(COPD)患者肺功能和血清炎症因子水平的影响。方法选择2017年1月至2018年9月该院收治的80例COPD患者为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组给予布地奈德福莫特罗吸入剂治疗,观察组加用噻托溴铵吸入剂(强化药物方案)治疗。比较两组患者的肺功能、血气指标、血清炎症因子水平、6min步行试验(6MWT)结果等。结果治疗后,观察组的第1秒用力呼气容积、用力肺活量和深吸气量明显高于对照组,氧分压和血氧饱和度高于对照组,二氧化碳分压低于对照组,血清C反应蛋白、白细胞介素-6和肿瘤坏死因子-α水平低于对照组,差异均有统计学意义(P<0.05)。治疗前两组患者的6MWT结果、COPD评估测试问卷(CAT)及改良的英国医学研究委员会呼吸困难量表(mMRC)评分相近(P>0.05),治疗后观察组的CAT和mMRC得分低于对照组,6MWT结果优于对照组,差异均有统计学意义(P<0.05)。结论布地奈德福莫特罗联合噻托溴铵可以明显改善COPD患者的肺功能和血气指标,提高运动耐力和生活质量,降低血清炎症因子水平,值得在临床推广应用。

Effect of intensive drug regimen on pulmonary function and inflammatory factors in chronic obstructive pulmonary disease patients

Objective To study the effect of intensive drug regimen on pulmonary function and inflammatory factors in chronic obstructive pulmonary disease(COPD)patients.Methods A total of 80 COPD patients who treated in Shanghai First People′s Hospital Baoshan Branch from January 2017 to September 2018 were randomly divided into control group(n=40)and observation group(n=40).Patients in control group were treated with budesonide formotello,while patients in observation group were treated with tiotropium bromide(intensive drug regimen)on the basis of the control group.The lung function,blood gas index,serum inflammatory factor level and 6 MWT result were compared between the two groups.Results After accepting treatment,compared with the indicators of control group,the levels of FEV1,FVC and IC in the observation group were higher,the levels of PaCO2 and SO2 in the observation group were also higher,and PaCO2 was lower,the levels of CRP,IL-6 and TNF-αin the observation group were lower(P<0.05).Before treatment,the result of 6 MWT,CAT and mMRC in the two groups were similar(P>0.05),the scores of CAT and mMRC in the observation group were lower and the result of 6 MWT was higher after accepting treatment compared with those of control group(P<0.05).Conclusion Budesonide formotello combined with tiotropium bromide could significantly improve the pulmonary function and blood gas index of COPD patients,improve exercise endurance and quality of life,reduce the level of serum inflammatory factors,which is worthy of clinical application.