噻托溴铵对慢性阻塞性肺疾病急性加重期患者血清炎性因子水平、肺功能的影响分析

The effect of tiotropium bromide on the serum inflammatory factors and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease

目的：探究并分析噻托溴铵对慢性阻塞性肺疾病（COPD）急性加重期血清炎性因子水平和肺功能的影响。方法选取2012年6月至2013年6月长治市人民医院收治的95例COPD患者，将其随机分成观察组48例和对照组47例，对照组进行常规治疗，观察组使用噻托溴铵治疗，观察两组患者血清炎症因子水平变化和肺功能情况，并进行分析比较。结果观察组患者接受治疗后TNF-α、IL-6和IL-8含量均较治疗前显著下降，治疗前后比较差异有统计学意义（P〈0.05）。对照组患者治疗12个月后，TNF-α、IL-6和IL-8水平也较治疗前下降，治疗前后比较差异无统计学意义（P〉0.05）。观察组患者治疗后FEV1、FEV1/FVC和FEV1（%）水平显著上升，患者肺功能明显好转，比较差异有统计学意义（P〈0.05）。12个月后，对照组患者FEV1、FEV1/FVC和FEV1（%）没有观察组改善明显，治疗前后比较差异无统计学意义（P〉0.05）。观察组患者治疗后PaO2显著上升，PaCO2降低，而对照组PaCO2和PaO2变化较小，两组比较差异有统计学意义（P〈0.05）。观察组不良反应发生率为12.50%，对照组无任何不良反应出现，两组比较差异有统计学意义（P〈0.05）。结论噻托溴铵能显著降低COPD急性加重期患者血清中各项炎症因子水平，减少炎症反应，同时进一步提高FEV1和PaO2的值，增强患者氧气吸入量，有效改善患者肺功能，不良反应症状轻微，安全性相对较高，临床疗效好，值得临床推广应用。

ObjectiveTo study and analyze the influence of the tiotropium for acute exacerbation of COPD and lung function in serum levels of inflammatory factors.Methods 95 cases of COPD patients as subjects in this study from June 2012 to June 2013 to come to our hospital for treatment,of were randomly divided into observation group and control group,the control group of conventional treatment,were randomly divided into observation group and control group,the control group of conventional treatment,the observation group were using tiotropium treatment,patients were observed in serum levels of inflammatory cytokines and lung function, the analysis and comparison.Results Observed in patients receiving treatment after TNF-α,IL-6 before and IL-8 content than before treatment significantly decreased after treatment was statistically significant （P〈0.05）.The control group patients after 12 months of treatment, the content of TNF-alpha, IL-6 content and IL-8 level was decreased compared with that before treatment, after treatment no statistical significance （P〉0.05）.Patients in the observation group after treatment, FEV1,FEV1/FVC and FEV1 （%） significantly increased levels of pulmonary function of patients,significantly improved,the data were statistically significant （P〈0.05）.After 12 months,patients in the control group FEV1,FEV1/FVC and FEV1 （%） without the observation group improved significantly after treatment,no statistical significance （P〉0.05）. After a significant increase in patients in the observation group PaO2,PaCO2 decreased,while the control group PaCO2 and PaO2 small changes,the two groups was statistically significant （P〈0.05）.Adverse reactions observed group was 12.50%,the control group without any adverse reactions occur, the probability is 0,the two groups was statistically significant （P〈0.05）.Conclusion Tiotropium significantly reduced in patients with acute exacerbation of COPD in the serum levels of inflammatory factors,reduce inflammation, and further increase the value of FEV1 and PaO2,increase the amount of oxygen inhalation patients,improve lung function,symptoms are mild adverse reactions,security is relatively high,good clinical efficacy,worth widely recommended for use in clinical practice.