吸入高剂量舒利迭对重度稳定期慢性阻塞性肺疾病的肺功能临床分析

Clinical analysis of high doses Seretide in the treatment of severe COPD of stabilization period

目的:探讨高剂量舒利迭(丙酸氟替卡松/沙美特罗)对重度稳定期慢性阻塞性肺疾病(COPD)患者肺功能的影响。方法:将76例重度稳定期COPD患者随机分为治疗组和对照组,每组各38例。两组均给予化痰、止咳、平喘等常规治疗,对照组加用异丙托溴铵20μg+沙丁胺醇100μg;治疗组加用丙酸氟替卡松50μg+沙美特罗500μg,两组均吸入给药,疗程均为12周。12周后比较两组患者肺功能改善情况。结果:治疗后,两组患者血气指标(PaO2、PaCO2)及肺功能指标(FVC、FEV1、FEV1/FVC)均较治疗前有所改善,差异有统计学意义(P<0.05);治疗后治疗组患者PaO2[(73.02±7.14)mm Hg]、PaCO2[(39.21±3.87)mm Hg]及FVC[(2.57±0.26)L]、FEV1[(1.91±0.19)L]、FEV1/FVC[(74.62±7.39)%]水平与对照组[(65.92±6.48)、(48.60±4.42)mm Hg、(2.34±0.27)、(1.63±0.17)L、(69.51±6.71)%]比较,差异均有统计学意义(P<0.05)。结论:高剂量的舒利迭可有效改善重度稳定期COPD患者肺功能,值得推广使用。

Objective： To investigate the impaction of Seretide （Fluticasone Propionate/Salmeterol） on the lung function of severe chronic obstructive pulmonary disease （COPD） of stabilization period. Methods： 76 cases of patients with severe COPD of stabilization period were randomly divided into treatment group and control group, each of 38 cases. All patients were treated with reducing phlegm, relieving cough, asthma and other conventional treatment. Patients of the control group were treated with Ipratropium Bromide 20 μg and Salbutamol 100 μg on the basis of conventional treatment, patients of the treatment group were treated with Fluticasone 50 p.g and Salmeterol 500 Ixg on the basis of conventional treatment. All patients were treated for 12 weeks. The changes of lung function of the two groups were compared after 12 weeks. Results： The blood gas analysis index （PaO2, PaCO2） and the lung function index （FVC, FEV1, FEV1/FVC） were compared before and after treatment between the two groups, the differences were statistically significant （P〈0.05）. After treatment the blood gas analysis index such as PaO2 [（73.02±7.14） mm Hg], PaCO2 [（39.21±3.87） mm Hg] and the lung function index such as FVC [（2.57±0.26） L], FEV1 [（1.91±0.19） L], FEV1/FVC [（74.62±7.39）%] of the treatment group were improved significantly than those of the control group [（65.92±6.48）, （48.60±4.42） mm Hg, （2.34±0.27）, （1.63±0.17）L, （69.51±6.71）%] （P〈0.05）. Conclusion： High doses Seretide can improve the lung function of patients with severe COPD of stabilization period effectively, it is worthy of clinical application.