噻托溴铵对稳定期COPD患者临床疗效及MMP-9的影响

Effect of Tiotropin Therapy on MMP-9 and clinical status of the patients with stable COPD

目的:观察噻托溴铵对稳定期慢性阻塞性肺病(COPD)患者的临床疗效及患者痰液及血清中基质金属蛋白酶-9(MMP-9)的影响。方法:160例稳定期COPD患者随机分为治疗组和对照组各90例,对照组予常规治疗,治疗组加用噻托溴铵吸入,3个月为一疗程。测定2组患者治疗前后肺功能、运动能力(6min步行距离)及呼吸困难评分,记录用药过程中的不良反应。结果:1个疗程后,与治疗前及治疗后的对照组相比,治疗组患者肺功能指标(FEV1/预计值、FEV1/FVC、PEF)明显升高,6min步行距离明显延长,呼吸困难分值显著下降(P<0.05或P<0.01);治疗组患者痰液及血清中MMP-9显著下降(P<0.01)。治疗组仅少数患者出现口干的不良反应。结论:噻托溴铵可明显改善稳定期COPD患者的肺功能、运动能力及呼吸困难,降低MMP-9含量可能是其作用机制之一。

OBJECTIVE To explore the effects of tiotropium on MMP-9 and clinical status in patients with stable chronic obstructive pulmonary disease （COPD） ; by analysing the curative effect and matrix metalloproteinases 9 （MMP-9） of the blood serum and sputum. METHODS 160 patients with stable COPD were randomly divided into two groups： tiotropium experimental group and regular treatment control group. All patients received 6 minute walk test, lung function test and the score of life quality before treatment and after 3 months of therapy respectively, and adverse effect was also registered in the procedure. RESULTS There were a significant difference between treatment group and control group in pulmonary function changes （FEV1%, FEV1/FVC, PEF）,6 minute walk test, clinical symptom （P〈0. 05）. The MMP-9 of blood serum and sputum was obviously lower in treatment group than in control group. A symptom of dry mouth was observed as adversereactior, CONCLUSION Tiotropium can improve lung functionm, locomotivity of COPD patients in stable phase, and the possible mechanism is the degression of MMP-9.