吸入糖皮质激素治疗稳定期COPD的疗效及对患者内皮功能及生活质量的影响

Effect of Inhaled Corticosteroids on the Pulmonary Function and Quality of Life in Patients with COPD in Stable Period

目的:探究吸入糖皮质激素(ICS)对慢性阻塞性肺疾病(COPD)患者一氧化氮(NO)、肺功能、内皮功能、生活质量影响临床疗效。方法:将2014年1月至2015年1月期间因稳定期COPD住院治疗患者中NO呼出量水平较高者40例纳入本研究,并将其随机均衡分为研究组和对照组,每组为20例。对照组患者采用常规抗炎等治疗,研究组患者在对照组基础上加上吸入糖皮质激素治疗。对比两组治疗前后肺功能,第1s用力呼气容积(FEV1)、第1s用力呼气容积/用力肺活量(FEV1/FVC)、最大呼气流量(PEF)、呼出气NO水平、内皮功能、生活质量(CAT评分)变化情况。结果:两组治疗后肺功能存在一定程度改善,且研究组FEV1、FEV1/FVC、PEF改善均明显优于对照组患者,差异具有统计学意义(P<0.05);治疗后,对照组IMT、VS、VD、RI和血清ET-1、sI cam-1较治疗前无明显差异(P>0.05),而研究组IMT、RI和血清ET-1、sI cam-1较治疗前降低,VS、VD较治疗前升高,差异具有统计学意义(P<0.05);治疗后,对照组血清呼出气NO和生活质量评分较治疗前无明显差异(P>0.05),而研究组呼出气NO、生活质量评分较治疗前降低,差异具有统计学意义(P<0.05)。结论:吸入糖皮质激素可以显著改善稳定期COPD患者肺功能,降低呼出气NO水平,提升内皮功能,生活质量也随之改善。

Objective： To explore the clinical effect of inhaled corticosteroid（ ICS） on the nitric oxide（ NO）,pulmonary function and quality of life in patients with chronic obstructive pulmonary disease（ COPD）. Method： From January 2014 to January 2015,40 cases hospitalized for COPD with high NO exhaled volume were selected and divided into study group and control group,20 cases in each group. The control group was treated with routine treatment,while the study group was treated with inhaled glucocorticoid on the basis of routine treatment. After a week of treatment,the pulmonary function of the patients,second forced expiratory volume（ FEV1）,forced expiratory volume in 1 second（ FEV1 / FVC）,Endothelial function were observed. Result： The pulmonary function of the two groups was improved,and the improvement of FEV1 / FVC and FEV1 in the study group were significantly better than those in the control group,and the difference was statistically significant（ P〈 0. 05）; After treatment,IMT,VS,VD,RI,and serum ET- 1,s Icam 1 of the control group had no obvious difference compared with those before treatment（ P〉 0. 05）,while IMT,RI and serum ET- 1,s Icam 1 in the study group reduced,VS,VD was higher than before treatment,the difference was statistically significant（ P〈 0. 05）; After treatment,the exhaled serum NO breath and quality of life scores in the control group had no obvious difference compared with those before treatment（ P〉 0. 05）,while breath NO,quality of life scores in the study group reduced,the difference was statistically significant（ P〈 0. 05）. Conclusion： Inhaled corticosteroids can improve the pulmonary function of patients with COPD,reduce the NO level of exhaled breath,improve the endothelial function and the quality of life.