长期家庭氧疗联合噻托溴胺粉剂对稳定期慢性阻塞性肺病患者的疗效观察

Therapeutic effect of long-term home oxygen therapy combined with tiotropium bromide in patients with chronic obstructive pulmonary disease in stable stage

目的探讨长期家庭氧疗联合噻托溴胺治疗慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法 80例COPD稳定期合并呼吸衰竭的患者随机分成两组,每组各40例,对照组单纯采用家庭氧疗,观察组给予噻托溴铵联合家庭氧疗。观察期为1年,比较两组再次住院率、治疗前后肺功能指标[FEV1、FEV1/FVC(%)及FEV1(%)]、运动耐量(6min步行距离,6MWD)及生活质量评分(SGRQ score)差异。结果 :观察组40%再住院率低于对照组77.5%(P<0.05);治疗后,两组FEV1、FEV1/FVC(%)、FEV1(%)、6MWD均明显提高,且观察组高于对照组(P<0.05)SGRQ评分均降低(P<0.05),且观察组低于对照组(P<0.05)。结论长期家庭氧疗联合噻托溴铵治疗可明显改善COPD稳定期患者肺功能、运动耐量和生活质量,并能减少再住院率。

Objective To investigate the therapeutic effect of long- term home oxygen therapy （LTOT）combined with tiotropium bromide in patients with chronic obstructive pulmonary disease in stable stage. Methods Totally 80 patients with COPD in stable stage were randomly divided into 2 groups, each group had 40 cases. The control group was treated with simple LTOT, and the observation group were treated with tiotropium bromide combined with LTOT. The re - hospi- talization rate, the pulmonary function [ FEV1 ,FEV1/ FVC（ % ）and FEV1 （%） ], the exercise tolerance（ 6 minute walk distance ,6 -MWD）and the quality of life （SGRQ score）were measured after 1 year treatment. Results （~） The re - hospitalization rate of the observation group was 40% , and it was significantly lower than that of the control group （77.5 %, X2 = 11. 605,P 〈 O. 05 ） ; ~） After treatment, the FEV1, FEV1/ FVC （ % ） and FEV1 （ % ） of two groups were significantly improved, and those of the observation group were higher than those of the control group（ P 〈 0. 05 ） ;~） Af- ter treatment, the 6MWD of two groups were increased, and it of the observation group was higher than that of the control group（ P 〈 0.05 ） ;（~） After treatment, the SGRQ score of two groups were decreased, and it of the observation group was higher than that of the control group （ P 〈 O. 05 ）. Conclusion The combination therapy of LTOT and tiotropium bromide can obviously improve the lung function, exercise tolerance and quality of life of COPD patients in stable stage, and can reduce the rate of re - hospitalization.