布地奈德联合噻托溴铵对哮喘-慢性阻塞性肺疾病重叠综合征患者炎性因子及肺功能指标的影响

Effect of tiotropium bromide on inflammatory factors and pulmonary function indexes in patients with asthma-chronic obstructive pulmonary overlap syndrome

目的探讨噻托溴铵对哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者炎性因子及肺功能指标的影响,为临床治疗提供参考。方法选取2017年1月—2019年3月河南省唐河县人民医院收治的64例ACOS患者作为研究对象,采用随机数字表法分为观察组和对照组,每组32例。对照组予以布地奈德治疗,观察组在对照组治疗基础上联合噻托溴铵治疗,两组均接受3个疗程的治疗。治疗前后,检测并比较两组白介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC及呼出气一氧化氮(FeNO)水平,记录并比较两组不良反应发生情况。结果治疗后,观察组IL-6和TNF-α水平均低于本组治疗前和同期对照组,差异有统计学意义(P<0.05)。治疗后,观察组FVC、FEV1、FEV1/FVC水平均高于本组治疗前和同期对照组,FeNO水平低于本组治疗前和同期对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率为21.88%,与对照组的18.75%比较,差异无统计学意义(P>0.05)。结论对ACOS患者加用噻托溴铵治疗可有效减轻机体炎症反应,改善肺功能,且无明显不良反应。

Objective To investigate the effect of tiotropium bromide on inflammatory factors and pulmonary function indexes in patients with asthma-chronic obstructive pulmonary overlap syndrome(ACOS).Methods Totally 64 patients with ACOS in Tanghe County People’s Hospital from January 2017 to March 2019 were divided into two groups by random number table,with 32 cases in each group.Two groups were given symptomatic treatment,and the control group was given budesonide inhalation therapy,while the observation group was treated with tiotropium bromide based on the control group.The inflammatory factors,pulmonary function,adverse reactions before treatment and after treatment for 3 courses were compared between the two groups.Results Compared with the control group,the levels of IL-6 and TNF-αin the observation group after treatment were lower,the FVC,FEV1 and FEV1/FVC in the observation group were higher,and the FeNO in the observation group was lower(P<0.05).There was no statistical difference in the incidence of adverse reactions between the observation group(21.88%)and the control group(18.75%)(P>0.05).Conclusion Tiotropium bromide in treatment of patients with ACOS can reduce inflammatory response,improve pulmonary function,and have no obvious adverse reactions.