噻托溴铵对轻中度慢性阻塞性肺疾病患者肺功能的影响

Effects of tiotropium on pulmonary function in patients with mild to moderate chronic obstructive pulmonary disease

目的评估噻托溴铵对轻中度慢性阻塞性肺疾病（COPD）患者肺功能的影响。方法将80例轻中度COPD患者按随机数字表法分为噻托溴铵组（40例）和对照组（40例），治疗周期为12周，两组患者均经过1周的清洗期，清洗期患者吸入0．9％氯化钠。第2～12周为治疗期，噻托溴铵组患者吸入噻托溴铵干粉胶囊（18μg／粒），上午给药，每日1次；对照组患者则继续吸入0．9％氯化钠。分别于治疗前及治疗后第6，12周测定患者的肺功能。结果经过连续12周的治疗后，噻托溴铵组肺功能指标深吸气量、第1秒用力呼气容积和用力肺活量均得到明显改善，较治疗前分别增加了（0．43±0．15），（0．17±0．11）和（0．41±0．14）L，而对照组上升幅度无明显改善，仅分别增加了（0．10±0．12），（0．01±0．05）和（0．05±0．12）L，两组比较差异有统计学意义（P〈0．05）。两组不良反应发生率和COPD急性发作率比较差异无统计学意义（P〉0．05）。结论轻中度COPD患者每日1次吸入噻托溴铵（18μg）可以显著改善患者的肺功能。

Objective To evaluate the effect of tiotropium on pulmonary function in patients with mild to moderate chronic obstructive pulmonary disease（COPD）. Methods Eighty mild to moderate COPD patients were divided into tiotropium group and control group with 40 cases in each group, the treatment period was 12 weeks. Patients in both groups after one week washout period, patients inhaled cleaning 0.9% sodium chloride. Two to 12 weeks of treatment period, patients in tiotropium group were given tiotropium bromide inhalation powder capsules （ 18 μg/grain）, administered morning a daily times ; patients in control group continued inhalation of 0.9% sodium chloride. The pulmonary function was assessed before treatment and on 6 and 12 weeks after treatment. Results After successive 12 weeks＇ treatment, the pulmonary function in tiotropium group were significantly enhanced. The inspiratory capacity, forced expiratory volume in one second and forced vital capacity were increased （0.43 ± 0.15 ）, （0.17 ± 0.11 ） and （0.41 ± 0.14） L, respectively; significantly higher than that in control group [ （0.10 ± 0.12） L, （0.01 ± 0.05） L and （0.05 ± 0.12） L], respectively; there were significant differences （P 〈 0.05 ）. There was no significant difference in the incidence of adverse reaction and the occurrence rate of COPD acute attack （P 〉 0.05）. Conclusion The pulmonary function was significantly improved in patients with mild to moderate COPD treated with tiotropium 18 μ g once daily.