高剂量沙美特罗替卡松联合等剂量噻托溴铵对高龄COPD稳定期患者肺功能及生活质量的影响

Effect of High-dose Salmeterol and Fluticasone Combined with Equaldose Tiotropium Bromide on Lung Functions and Quality of Life in Elderly Patients with Stable COPD

目的:研究高剂量沙美特罗替卡松联合等剂量噻托溴铵对高龄慢性阻塞性肺部疾病(COPD)稳定期患者肺功能及生活质量的影响.方法:选取我院2014年3月—2016年9月收治的88例高龄COPD稳定期患者,按治疗方案不同分为两组,各44例.对照组采取低剂量沙美特罗替卡松(50μg/250μg,bid)联合噻托溴铵(18μg,qd)治疗,观察组采取高剂量沙美特罗替卡松(50μg/500μg,bid)联合等剂量噻托溴铵治疗,比较两组治疗效果、治疗前后肺功能[1 s用力呼气容积(FEV1)、用力肺活量(FVC)、1 s用力呼气容积占用力肺活量百分比(FEV1/FVC)]、生活质量(SF-36)评分.结果:观察组总有效率为95.45%,高于对照组的75.00%,差异有统计学意义(P<0.05);治疗前,两组FEV1、FVC、FEV1/FVC、SF-36评分比较,差异无统计学意义(P>0.05);治疗1年后,观察组FEV1、FVC、FEV1/FVC、SF-36评分高于对照组,差异有统计学意义(P<0.05).结论:高剂量沙美特罗替卡松联合等剂量噻托溴铵治疗高龄COPD稳定期患者的疗效显著,可显著改善患者的肺功能,提高生活质量.

Objective:To study the effect of high-dose salmeterol and fluticasone combined with equal-dose tiotropium bromide on lung functions and quality of life in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods:88 patients with stable COPD admitted to our hospital from March 2014 to September 2016 were selected and divided into two groups according to different treatment options,44 cases each.The patients in the control group were treated with low-dose salmeterol and fluticasone(50μg/250μg,bid)combined with tiotropium bromide(18μg,qd),and the patients in the observation group were treated with high-dose salmeterol and fluticasone(50μg/500μg,bid)combined with equal-dose tiotropium bromide.The therapeutic effect,lung functions before and after treatment[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC)]before and after treatment,and quality of life(SF-36)scores were compared between the two groups.Results:The total effective rate in the observation group was 95.45%,which was higher than 75.00%in the control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in FEV1,FVC,FEV1/FVC and SF-36 scores before treatment between the two groups(P>0.05).After one year of treatment,the FEV1,FVC,FEV1/FVC and SF-36 scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:High-dose salmeterol and fluticasone combined with equal-dose tiotropium bromide have a significant therapeutic effect on stable COPD in elderly patients,which can significantly improve lung functions and improve the quality of life of the patients.