噻托溴铵及氨茶碱对稳定期慢性阻塞性肺病患者气道重塑的影响

Effect of tiotropium and aminophylline on airway remodeling in stable COPD patients

目的:评价噻托溴铵及氨茶碱对中、重度稳定期慢性阻塞性肺疾病(COPD)患者气道重塑的影响。方法:采用随机对照研究140例COPD患者,噻托溴铵组使用噻托溴铵干粉剂,氨茶碱组使用氨茶碱片,总观察时间12周,治疗前后酶联免疫吸附测定痰中TGF-β1。结果:治疗前噻托溴铵组TGF-β1阳性率为62.5%,氨茶碱组为66.7%,治疗后噻托溴铵组TGF-β1阳性率为37.5%,氨茶碱组为65.0%。治疗前,2组TGF-β1阳性率无明显差异(P>0.05),具有可比性,治疗后噻托溴铵组明显低于氨茶碱组(P<0.01)。噻托溴铵组治疗前后有显著差异(P<0.01),而氨茶碱组无显著差异(P>0.05)。结论:噻托溴铵对中、重度稳定期COPD患者的气道重塑具有显著的改善作用,而氨茶碱无显著改善。

OBJECTIVE To research the effect of tiotropium （M3receptor antagonist） and arninophylline on airway remodeling in stably moderate and severe chronic obstructive pulmonary disease （COPD）. METHODS A randomized controlled clinical trail was conducted in 140 patients with COPD. 81） patients were treated by tiotropium （18μg, qd inhaled） and 60 patients were treated by aminophylline for 12 weeks. ELISA was applied to detect TGF -β1. RESULTS TGF-β1 positive rate in tiotropium group （62. 5 percent） was the same to aminophylline group （66. 7 percent） before treatment（P〉0. 05）. TGF-β1 positive rate in tiotropium group （37. 5 percent） was significantly less than that of aminophylline group （65.0 percent） after treatment （P〈0. 01）. After treatment,TGF-β1 positive rate was significantly less than before treatment in tiotropium group,TGF-β1 positive rate was the same to before treatment in aminophylline group. CONCLUSION Tiotropium is an significant effective bronchodaliator for improving airway remodeling in patients with stably moderate and severe COPD, but aminophylline is not signifi- cant.