噻托溴铵联合沙美特罗替卡松对慢阻肺急性加重期患者免疫功能的影响

Effect of tiotropium joint salmeterol fluticasone propionate on immune function in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探究噻托溴铵联合沙美特罗替卡松对慢性阻塞性肺急性加重期患者免疫功能的影响。方法随机选取我院2013年3月至9月收诊的慢阻肺急性加重期患者78例,按其入院先后顺序分为观察组(40例)与对照组(38例)。给予对照组患者噻托溴铵药物治疗;给予观察组患者联合沙美特罗替卡松药物治疗,观察两组患者治疗前后PCT、CRP水平、FEV_1、FVC及FEV_1/FVC值等变化情况。结果经治疗,两组患者PCT及CRP均明显降低且观察组效果明显优于对照组(P<0.05);两组患者FEV_1、FEV_1/FVC及FEC预计值较治疗前均明显改善,且观察组效果明显优于对照组,差异显著(P<0.05);两组患者PaO_2及PaCO_2水平均明显改善,对照组PaO-_2及PaCO_2水平(64.3±3.8)mm Hg,(54.3±3.8)mm Hg明显低于观察组(74.2±3.6)mm Hg,(47.6±4.4)mm Hg,差异显著(P<0.05);两组患者TNF-α与IL-6水平均明显降低,且观察组降低程度明显高于对照组;两组患者不良反应发生率无显著性统计学差异(P>0.05)。结论噻托溴铵联合沙美特罗替卡松治疗慢阻肺急性加重期患者,可有效协助患者恢复其肺功能、提高免疫力等,具有良好推广价值。

Objective To analyze the effect of tiotropium joint salmeterol fluticasone propionate on immune function in patients with AECOPD. Methods 78 AECOPD patients from March 2013 to September 2013 were ran- domly divided into two groups according to the order of their admission. The control group was given thiophene tiotro- pium therapy, and the observation group was given salmeterol and fluticasone propionate therapy. Their PCT, CRP levels, FEV1, FVC and FEVI/FVC were detected. Results After the treatment, their PCT and CRP levels im- proved effectively, and the improvement was more pronounced in the observation group than in the control group （P 〈 0.05 ）. The levels of FEV1, FVC and FEVI/FVC were much better in the observation group than in the control group （P 〈0. 05）. The level of PO2 and PCOz were （64. 3 ±3.8） mmHg and （54. 3±3. 8） mrnHg in the control group, which were significantly lower than those in the observation group [ （ 74.2 ± 3.6） mmHg, （ 47.6 ±4.4） mmHg ] （ P 〈 0.05 ）. TNF-α and IL-6 were significantly lower after the treatment than before, and they were significantly bet- ter in the observation group than in the control group （P 〈 0. 05 ）. There was no significant difference in adverse reactions between the two groups. Conclusion Tiotropium salmeterol and fluticasone can effectively help AECOPD patients recovering from lung function, and improve their immunity, which is worthy of further application.