长期吸入沙美特罗替卡松(舒利迭)对稳定期中重度COPD患者肺功能和肺动脉高压的改善作用的研究

Improvement of Salmeterol Fluticasone( Seretide) Long Term Inhalation in Lung Function and Pulmonary Hypertension on Patients with Moderate and Severe COPD

目的:探讨长期吸入沙美特罗替卡松(舒利迭)对稳定期中重度COPD患者肺功能和肺动脉高压的改善作用的研究。方法:选取2014年2月-2015年3月在本院住院治疗的稳定期中重度COPD患者96例,按随机数字表法分为观察组49例和对照组47例,对照组患者出院后均按出院指导内容进行家庭康复,并根据病情给予稀释痰液药物、茶碱类药物、抗生素、对症治疗,观察组患者在上述治疗的基础上给予沙美特罗替卡松(舒利迭)50μg/500μg吸入治疗,2次/d,1吸/次。两组患者均于出院后6个月测定患者肺通气功能、平均肺动脉压(m PAP),并采用圣乔治医院呼吸问卷(SGRQ)评估生活质量,根据美国胸科协会5级分级法评价临床疗效。结果:治疗前,两组患者FEV1、FVC、FEV1%、m PAP比较差异均无统计学意义(P>0.05),治疗后两组患者的FEV1、FVC、FEV1%均明显升高,m PAP均明显降低,差异均具有统计学意义(P<0.05);治疗后,观察组FEV1、FVC、FEV1%均明显高于对照组(P<0.05),m PAP明显低于对照组(P<0.05);治疗前,两组患者临床症状、活动、疾病影响等生活质量评分比较差异均无统计学意义(P>0.05),治疗后均明显降低(P<0.05),且观察组降低幅度明显大于对照组(P<0.05);观察组患者治疗总有效率为85.71%(42/49),对照组为68.09%(32/47),组间差异具有统计学意义(P<0.05)。结论:沙美特罗替卡松吸入治疗稳定期中重度COPD可有效改善肺功能,降低肺动脉高压,同时可有效改善生活质量,疗效优于常规治疗。

Objective： To discuss the improvement of salmeterol fluticasone （ Seretide ） long term inhalation in lung function and pulmonary hypertension on patients with moderate and severe COPD. Method： 96 patients with moderate and severe COPD were selected and randomly divided into the observation group for 49 cases and the control group for 47 cases in our hospital from February 2014 to March 2015, patients in control group received routine family rehabilitation, and given dilute sputum drug, theophylline, antibiotics, symptomatic treatment, and observational group added salmeterol fluticasone （ Seretide ） 50/500 μg inhalation on the basis of the above control group, 2 times a day, 1 absorption a time.The lung function, mean pulmonary artery （ mPAP ） were determined before and six months after treatment, and the quality of life were assessed by St.George＇s Hospital Respiratory Questionnaire （ SGRQ ）, the clinical efficacy were evaluated by American Thoracic Society 5 grading.Result： Before treatment, there were no statistically significant differences between two groups on FEV1, FVC, FEV1%, mPAP （P〉0.05）, FEV1, FVC, FEV1% of the observation group and the control group were significantly increased, and both mPAP were significantly reduced six months after treatment （P〈0.05） .After treatment, the FEVI, FVC, FEV1% of the observation group were significantly higher than those of the control group, mPAP were significantly lower than the control group （ P〈0.05 ） .Before treatment, there were no statistically significant differences between two groups on the SGRQ scores （ P〉0.05 ）, and both groups significantly reduced after treatment （ P〈0.05 ）, and the change of the observation group was significantly bigger than that of the control group （ P〈0.05 ） .The total effective rate of the observational group was 85.71% （ 42/49 ）, the control group was 68.09% （ 32/47 ）, the difference was statistically significant （ P〈0.05 ） . Conclusion： Salmeterol fluticasone （ Seretide ） long term inhalation treatment for moderate and severe COPD can improvethe lung function, reduce pulmonary hypertension, and can improve quality of life, the curative effect is superior to conventional treatment.