沙美特罗替卡松粉吸入剂联合双水平气道正压通气对慢性阻塞性肺疾病稳定期患者肺功能和生活质量的影响分析

Affection of salmeterol/fluticasone combined with bi-level positive airway pressure ventilation on lung function and life quality in treatment of chronic obstructive puhnonary disease stable phase patients

目的分析沙美特罗替卡松粉吸人剂联合双水平气道正压通气对慢性阻塞性肺疾病（COPD）稳定期患者肺功能和生活质量的影响。方法将104例中重度COPD稳定期患者按随机数字表法分为两组，每组52例，观察组采用沙美特罗替卡松粉吸入剂联合双水平气道正压通气治疗，对照组仅采用双水平气道正压通气治疗，观察比较两组治疗前后的肺功能和生活质量。结果观察组治疗后第1秒用力呼气容积（FEV。）、FEV。占用力肺活量（FVC）百分比（FEV．／FVC）和75％肺活量最大呼气流量（FEF75）分别为（2．27±0．45）L、（69．12±7．71）％、（0．62±0．22）L／s，较治疗前的（1．55±0．30）L、（55．65±5．11）％、（0．31±0．13）L／s均明显升高，差异有统计学意义（P〈0．05）；对照组治疗后FEV1、FEVl／FVC和FEF75分别为（1．87±0．39）L、（62．79±6．86）％、（0．45±0．18）L／s，较治疗前的（1．56±0．31）L、（55．69±5．13）％、（0．32±0．14）L／s明显升高，差异有统计学意义（P〈0．05）；观察组治疗后FEV1、FEV1／FVC和FEF75明显高于对照组，差异有统计学意义（P〈0．05）。观察组治疗后呼吸症状、活动受限、疾病影响及圣·乔治呼吸问卷（SGRQ）总分分别为（24．15±9．68）、（21．39±7．43）、（18．61±6．39）、（21．85±8．14）分，较治疗前的（59．28±17．70）、（44．15±13．91）、（46．54±14．58）、（48．86±15．75）分明显降低，差异有统计学意义（P〈0．05）；对照组治疗后呼吸症状、活动受限、疾病影响及SGRQ总分分别为（42．36±12．19）、（36．28±9．35）、（29．35±8．24）、（33．69±9．26）分，较治疗前的（58．72±17．65）、（43．21±13．46）、（45．67±14．29）、（48．37±15．42）分明显降低，差异有统计学意义（P〈0．05）；观察组治疗后呼吸症状、活动受限、疾病影响及SGRQ总分明显低于对照组，差异有统计学意义（P〈0．05）。结论沙美特罗替卡松粉吸人剂联合双水平气道正压通气对COPD稳定期患者进行治疗，能够明显改善患者的肺功能，提高生活质量，值得临床推广应用。

Objective To analyze the affection of salmeterol/fluticasone combined with bi-level positive airway pressure ventilation on lung function and life quality in treatment of chronic obstructivepulmonary disease （COPD） stable phase patients. Methods One hundred and four moderate and severe COPD stable phase patients were divided into two groups by random digits table with 52 cases each,Observation group were treated with salmeterol/fluticasone combined with bi-level positive airway pressureventilation, and control group were treated with bi-level positive airway pressure ventilation. The lung function and life quality between two groups were compared. Results The levels of forced expiratory volume in one second （FEV1）, FEV1/forced vital capacity （FVC） and 75 percent of forced expiratory flow （FEF75） aftertreatment were higher than those before treatment in obseration group[ （2.27 ±0.45） L vs. （ 1.55±0.30） L, （69.12±7.71）% vs. （55.65±5.11）%, （0.62±0.22） L/s vs. （0.31±0.13） L/s] and control group[ （ 1.87 ±0.39 ） L vs.（ 1.56 ±0.31 ） L, （62.79±6.86 ）% vs. （55.69 ±5.13 ）%, （0.45 ±O. 18 ） L/s vs. （0.32±0.14）L/sl with significant differences （P 〈0.05）, and the levels of FEVI, FEVJFVC and FEF75 after treatment in observation group were higher than those in control group with significant differenees（P 〈 0.05 ）.The scores of respiratory symptoms, activity limitation, disease impact and St. George respiratory questionnaire （SGRQ） total score after treatment were lower than those before treatment in observation group[（24.15±9.68） scores vs. （59.28±17.70） scores, （21.39±7.43） scores vs. （44.15±13.91） scores, （ 18.61 ±6.39） scores vs. （46.54±14.58） scores, （21.85±8.14） scores vs. （48.86±15.75） scores] andcontrol group [ （42.36±12.19） scores vs. （58.72±17.65） scores, （36.28±9.35） scores vs. （43.21±13.46） scores , （29.35±8.24） scores vs. （45.67±14.29） scores, （33.69±9.26） scores vs. （48.37±15.42） scores] with significant differences （P 〈0.05）,and the scores of respiratory symptoms, activity limitation, disease impact and SGRQ total score in observation group were lower than those in control group with significant differences （P〈 0.05）. Conclusions Salmeterol/fluticasone combined with bi-level positiveairway pressure ventilation in treatment of COPD stable phase can improve lung function, and enhance life quality, which can be applied in clinic.