观察噻托溴铵联合氨茶碱对慢性阻塞性肺疾病患者肺功能和炎症因子的干预作用

Interventional effect of tiotropium bromide combined with aminophylline on pulmonary function and inflammatory factors of patients with chronic obstructive pulmonary disease

目的：探讨噻托溴铵联合氨茶碱对慢性阻塞性肺疾病（COPD）患者肺功能和相关炎症因子的干预作用。方法：选择2013年1月~2015年12月在重庆市长寿区人民医院接受治疗并确诊为COPD的患者170例,随机分为A组（观察组,n=85）和B组（对照组,n=85）。B组患者接受氨茶碱治疗（0.1g/次,2次/d）,A组在B组治疗的基础上外加噻托溴铵（18μg/次,1次/d）,疗程2个月。取样分析两组患者治疗前后白细胞介素-8（IL-8）、C反应蛋白（hs-CRP）和肿瘤坏死因子-α（TNF-α）的水平;通过胸部CT检查计算患者气道壁面积占总横截面百分比（WA%）、壁厚与气管壁外径比值（T/D）等气道重塑指标;通过肺功能测试仪检测患者肺功能指标。结果：治疗后,两组患者相关炎症因子IL-8、hsCRP和TNF-α水平,以及WA%和T/D气到重塑指标均明显下降（P〈0.05）,而且A组炎症因子水平和气到重塑指标的下降幅度显著大于B组（P〈0.05）;两组患者肺功能指标FEV1、FVC、FEV1/FVC显著改善（P〈0.05）,而且A组明显优于B组（P〈0.05）。A组和B组的治疗总效率分别为88.24%和74.12%,A组显著高于B组（χ2=5.543,P〈0.05）。结论：噻托溴铵联合氨茶碱可显著降低COPD患者炎症因子水平,有效改善肺功能,临床治疗疗效满意。

Objective：To observe the interventional effect of tiotropium bromide combined with aminophylline on pul-monary function and inflammatory factors of patients with chronic obstructive pulmonary disease （COPD）.Methods：A total of 1 70 cases of patients with COPD in our hospital from January 2013 to December 201 5 were selected and randomly divided into the Group A （observation group,n =85）and Group B （control group,n =85）.The Group B was treated with aminophylline （0.1 g/time,2 times /d）,the Group A received tiotropium bromide （18 μg/time,1 time/d）on the basis of the Group B.The levels of interleukin-8 （IL-8）,high sensitive C reactive protein （hs-CRP）and tumor necrosis factor alpha （TNF-α）were detec-ted.The index of airway remodeling in patients with chest CT examination,pulmonary function indices were detected by chestnbsp;pulmonary function instrument.Results：After treatment,the levels of inflammatory factors IL-8,hs-CRP and TNF-α,and the indices of airway remodeling WA% and T/D in two group were significantly decreased （P 〈0.05）,while levels of inflammato-ry factors and index of airway remodeling in Group A were significantly lower than that of in Group B （P 〈0.05）.The FEV1, FVC and FEV1/FVC of lung function indices were significantly improved in patients of two group （P 〈0.05）,while the Group A was better than Group B （P 〈0.05）.The total efficiency of Group A and Group B were 88.24% and 74.12% respectively. The Group A was significantly higher than the Group B （χ2 = 5.543,P 〈0.05 ）.Conclusions：Tiotropium bromide combined with aminophylline can significantly reduce the inflammatory factor level in patients with COPD and effectively improve the pulmonary function,with satisfactory curative effect in clinical treatment.