噻托溴胺对慢性阻塞性肺疾病稳定期患者生存质量的评价

Evaluation of Inhaling Tiotropium in Stable Chronic Obstructive Pulmonary Disease

目的观察中度慢性阻塞性肺疾病(COPD)稳定期吸入噻托溴胺的临床疗效。方法将40例中度COPD(Ⅱ～Ⅲ级)稳定期患者随机分为2组,治疗组(噻托溴铵组)(n=20,思力华,Boehinger Ingelheim,18ug,1次/d,早晨给药)和对照组(n=20,按需使用短效抗胆碱能支气管扩张剂),整个观察期为1年,观察2组用药3个月、6个月和1年后肺功能的变化以及StGeorge′s呼吸问卷(SGRQ)等情况,通过6min步行试验(6MWT)观察运动耐力的变化以及随访3～12个月急性加重的例次及住院例次。结果用药3个月后治疗组FEV1、FVC、FEV1/FVC及FEV1占预计值(%)比对照组明显改善,2组比较差异有显著性(P<0.05),治疗组运动耐力(6MWT)增加,SGRQ评分比较治疗组明显下降,随访3～12个月治疗组急性加重例次明显减少,与对照组比较差异有显著性(P<0.05);治疗组用药后3个月、6个月和1年后肺功能比较无显著差异(P>0.05)。结论吸入噻托溴胺可以改善稳定期(Ⅱ～Ⅲ级)COPD患者肺功能与运动耐力,减少急性加重的发作,改善生活质量,不良反应少,使用方便,值得临床广泛推广。

Objective To observe the benefits of therapy with inhaling of tiotropium in stable chronic obstructive pulmonary disease. Methods Forty patients with stable COPD were randomly＂ divided into trial and control groups. Baseline treatments were similar in all patients. 20 patients in trial group received tiotropium inhalation once a day for one year. The other 20 patients in control group didn＇t inhale tiotropium. Before and after the therapeutic course, tests for lung function in patients of these two groups were examined and compared with each other. According to the method of standard grade of respiratory diseases questionnaire （SGRQ） and 6 mintue walk test （6MWT） were compared of two groups after three months. Oberver the proportion of hospitalized patients due to AECOPD occurred of two groups. Results The values of FEV1/FVC and FEV1 /predictive value in trial group were significantly increased in different extent than the control group （ P 〈 0. 05 ） after three momths. In trial group, the value of SGRQ became significantly lower than that the control group （ P 〈 0. 05 ）. In trial group, the proportion of hospitalized patients due to AECOPD was lower than that of control group （ P 〈 0. 05 ） and the 6MWT was improved significantly （ P 〈 O. 05）. Contusion Tiotropium can effectively improve lung function, exercise endurance and health status in patient s with stable COPD.