布地奈德福莫特罗吸入剂治疗老年COPD不同气道炎症水平的疗效研究

Clinical effect of budesonide formoterol inhalant in the treatment of senile chronic obstructive pulmonary disease patients with different levels of airway inflammation

目的分析布地奈德福莫特罗吸入剂治疗老年COPD病人不同气道炎症水平的有效性与安全性。方法选取我院2016年1月至2018年5月门诊就诊的126例老年COPD病人,根据慢性阻塞性肺疾病全球倡议(GOLD)分级分为轻度组(40例)、中度组(51例)、重度组(23例)和极重度组(12例),全部病人均接受布地奈德福莫特罗吸入剂(1吸/次,2次/d)连续治疗2个月。治疗前后检测并比较各组痰液炎症指标IL-8、TNF-α、CRP及肺功能指标FEV1%pred、FEV1/FVC水平,同时观察治疗期间病人不良反应发生情况。结果治疗前,4组病人痰液IL-8、TNF-α、CRP水平随分级情况加重呈升高趋势,组间比较,差异均有统计学意义(P<0.05);治疗结束时,4组痰液IL-8、TNF-α、CRP水平均较治疗前降低(P<0.05);4组间比较,差异亦有统计学意义(P<0.05)。治疗前,4组FEV1%pred、FEV1/FVC水平随着气道炎症水平分级加重而降低,组间比较,差异有统计学意义(P<0.05);治疗结束时,4组FEV1%pred、FEV1/FVC肺功能指标水平均较治疗前提高(P<0.05),4组间比较,差异亦有统计学意义(P<0.05)。治疗期间病人均无不良反应发生。结论布地奈德福莫特罗吸入剂对不同气道炎症水平老年COPD病人的抗炎效果理想,病人肺功能有所改善,无不良反应,安全可靠。

Objective To analyze the efficacy and safety of budesonide formoterol inhalant in treatment of senile chronic obstructive pulmonary disease(COPD)patients with different levels of airway inflammation.Methods A total of 126 senile COPD outpatients from January 2016 to May 2018 in our hospital were enrolled.They were divided into mild group(40 cases),moderate group(51 cases),severe group(23 cases),extremely severe group(12 cases)according to the the global initiative for chronic obstructive lung disease(GOLD).All the patients received budesonide formoterol inhalant with 1 inhalation/time,Bid,for 2 months.The levels of airway inflammation indexes[interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],and the pulmonary function[first second forced expiratory volume as a percentage of predicted value(FEV1%pred),forced expiratory volume in the first second/forced vital capacity(FEV1/FVC)]were observed and compared before and after treatment.The adverse reactions of patients during treatment were recorded.Results Before treatment,the levels of IL-8,TNF-α,CRP in the sputum of the four groups increased with the aggravation of grading(P<0.05).At the end of treatment,the levels of IL-8,TNF-α,CRP in the sputum of the four groups decreased compared with those before treatment,and the differences among the four groups were statistically significant(P<0.05);And they increased with the aggravation of grading(P<0.05).Before treatment,the levels of FEV1%pred and FEV1/FVC in the four groups decreased with the aggravation of airway inflammation grading(P<0.05).After treatment,the levels of FEV1%pred and FEV1/FVC in the four groups were significantly higher than those before treatment respectively(P<0.05);And they decreased with the aggravation of grading(P<0.05).No adverse reactions were observed during the treatment in all patients.Conclusions Budesonide formoterol inhalant can achieve ideal anti-inflammatory effects,improve pulmonary function with no adverse reactions in treatment of senile COPD patients with different levels of airway inflammation,which is safe and reliable.