沙美特罗替卡松粉吸入剂应用于慢阻肺稳定期患者的效果及对CTRP-4、CTRP-5水平的影响分析

Effect of salmeterol xinafoate and fluticasone propionate powder for inhalation on patients with stable chronic obstructive pulmonary disease and its influence on CTRP-4 and CTRP-5 levels

目的探究沙美特罗替卡松粉吸入剂应用于慢性阻塞性肺疾病(慢阻肺)稳定期患者的效果及对肿瘤坏死因子相关蛋白(CTRP)-4、CTRP-5水平的影响。方法以慢阻肺稳定期患者70例作为研究对象,随机分为参照组及研究组,各35例。参照组应用常规治疗,研究组在参照组基础上添加沙美特罗替卡松粉吸入剂治疗。比较两组治疗效果,治疗前后的肺功能指标[第1秒用力呼气容积占预计值的百分比(FEV1%)、用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)]、炎症因子[白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、血清转化生长因子-β(TGF-β)]及CTRP-4、CTRP-5水平,不良反应发生率。结果研究组总有效率97.14%高于参照组的80.00%(P<0.05)。治疗后,两组患者FVC、FEV1%、FEV1/FVC水平均明显高于治疗前,且研究组治疗后FVC(3.41±0.41)L、FEV1%(85.33±7.74)%、FEV1/FVC(76.40±6.66)%高于参照组的(2.07±0.23)L、(80.47±6.64)%、(71.40±5.51)%(P<0.05)。治疗后,两组患者IL-17、TNF-α、TGF-β均低于治疗前,且研究组治疗后IL-17(0.65±0.23)ng/L、TNF-α(32.89±5.27)pg/ml、TGF-β(256.37±67.17)ng/L均低于参照组的(1.56±0.29)ng/L、(42.09±5.45)pg/ml、(304.64±82.21)ng/L(P<0.05)。治疗后,两组患者CTRP-4、CTRP-5水平均低于治疗前,且研究组患者治疗后CTRP-4(7.26±0.84)μg/ml、CTRP-5(0.26±0.07)μg/ml均低于参照组的(8.97±0.75)、(0.33±0.06)μg/ml(P<0.05)。两组患者不良反应发生率比较无差异(P>0.05)。结论慢阻肺稳定期患者采用沙美特罗替卡松粉吸入剂治疗,可有效缓解临床症状,改善肺功能,控制CTRP-4、CTRP-5水平,提高治疗总有效率,安全性高,可广泛应用于临床。

Objective To explore the effect of salmeterol xinafoate and fluticasone propionate powder for inhalation on patients with stable chronic obstructive pulmonary disease and its influence on tumor necrosis factor-related protein(CTRP)-4 and CTRP-5 levels.Methods 70 patients with stable chronic obstructive pulmonary disease were randomly divided into a reference group and a study group,with 35 patients in each group.The reference group received conventional treatment,and the study group received salmeterol xinafoate and fluticasone propionate powder for inhalation based on the reference group.Both groups were compared in terms of therapeutic effect,lung function indicators[forced expiratory volume in one second as a percentage of the predicted value(FEV1%),forced vital capacity(FVC),ratio of forced expiratory volume in one second to FVC(FEV1/FVC)],inflammatory factors[interleukin-17(IL-17),tumor necrosis factor-α(TNF-α),serum transforming growth factor-β(TGF-β)],CTRP-4,CTRP-5 level before and after treatment,and incidence of adverse reactions.Results The total effective rate of the study group was 97.14%,which was higher than 80.00%of the reference group(P<0.05).After treatment,the levels of FVC,FEV1%and FEV1/FVC in both groups were significantly higher than those before treatment;the study group had FVC of(3.41±0.41)L,FEV1%of(85.33±7.74)%and FEV1/FVC of(76.40±6.66)%,which were higher than(2.07±0.23)L,(80.47±6.64)%and(71.40±5.51)%in the control group(P<0.05).After treatment,IL-17,TNF-αand TGF-βin both groups were lower than those before treatment;the study group had IL-17 of(0.65±0.23)ng/L,TNF-αof(32.89±5.27)pg/ml and TGF-βof(256.37±67.17)ng/L,which were all lower than(1.56±0.29)ng/L,(42.09±5.45)pg/ml and(304.64±82.21)ng/L in the reference group(P<0.05).After treatment,CTRP-4 and CTRP-5 levels in both groups were lower than those before treatment;the study group had CTRP-4 of(7.26±0.84) μg/ml and CTRP-5 of (0.26±0.07) μg/ml, which were lower than (8.97±0.75) and (0.33±0.06) μg/ml in the reference group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Salmeterol xinafoate and fluticasone propionate powder for inhalation for patients with stable chronic obstructive pulmonary disease can effectively relieve clinical symptoms, improve lung function, control CTRP-4 and CTRP-5 levels, improve the total effective rate of treatment, and have high safety, which can be widely used in clinical practice.