噻托溴铵对重症哮喘患者肺功能和血气指标的影响

Effects of tiotropium bromide on pulmonary function and blood gas parameters in patients with severe asthma

目的观察噻托溴铵治疗重症哮喘的疗效及其对患者肺功能与血气指标的影响。方法选择84例重症哮喘患者为研究对象,随机分为观察组和对照组,各42例。对照组给予常规治疗,观察组在此基础上给予噻托溴铵吸入剂治疗。观察临床疗效以及2组患者治疗前与治疗后6个月肺功能、血气分析指标的变化。结果观察组总有效率为88.10%,显著高于对照组(59.52%)(P<0.01);与治疗前比较,治疗后2组患者用力肺活量(FVC)、第1秒末用力呼气容量(FEV1)、FEV1占FVC比值(FEV1%)以及动脉血氧分压(PaO2)显著升高(P<0.01),动脉血二氧化碳分压(PaCO2)显著降低(P<0.01);组间比较,治疗后观察组FVC、FEV1、FEV1%以及PaO2显著高于对照组(P<0.05或P<0.01),PaCO2显著低于对照组(P<0.01);观察组总不良反应发生率为26.19%,与对照组(16.67%)相比,差异无统计学意义(P>0.05)。结论噻托溴铵治疗重症哮喘疗效显著,能够改善患者肺功能,且不增加药物不良反应,值得临床推广。

Objective To observe the clinical effects of tiotropium bromide on pulmonary function and blood gas parameters in patients with severe asthma.Methods A total of 84 patients with severe asthma were randomly divided into observation and control group,42 cases in each group.Conventional treatment was performed in both groups and additional tiotropium bromide was administrated to observation group.The short-term clinical efficacy,changes in pulmonary function and blood gas parameter before treatment and 6months after treatment were observed.Results The overall response rate in observation group（88.10%）was significantly higher than in control group（59.52%）.Forced vital capacity（FVC）,forced expiratory volume in 1second（FEV1）,the rate of FEV1 to FVC（FEV1%）and PaO2 in both two groups increased after treatment,PaCO2decreased（P〈0.01）.Patients in observation group achieved higher FVC,FEV1,FEV1% and PaO2（P〈0.05 or P〈0.01）,but lower PaCO2（P〈0.01）compared to control group.There was no significant difference in adverse events between two groups（26.19% ︰ 16.67,P〉0.05）.Conclusion Tiotropium bromide shows protential effects on severe asthma,which improves the pulmonary function without increasing adverse events.