沙美特罗/氟替卡松吸入对不同影像学表型的慢性阻塞性肺疾病的疗效观察

Efficacy of salmeterol/fluticasone inhalation in patients with chronic obstructive pulmonary disease with different radiologic phenotypes

目的观察沙美特罗/氟替卡松吸入对不同影像学表型的慢性阻塞性肺疾病(COPD)的疗效。方法按照2011年COPD全球倡议选取C、D级的COPD稳定期患者91例,予胸部高分辨CT(HRCT)检查,根据HRCT特征,将患者分为A型(5例)、E型(46例)、M型(40例)。选择E型、M型两组患者为研究对象,均予沙美特罗/氟替卡松吸入剂(50/500μg,2次/d)治疗。观察两组患者用药前和用药6、12个月后的肺功能、CAT评分、6min步行距离。结果用药6、12个月后两组患者的肺功能、CAT评分、6min步行距离均较治疗前明显改善(P<0.01),M型组CAT评分、6min步行距离改善程度优于E型组(P<0.05)。结论影像学表型为M型的COPD患者对沙美特罗/氟替卡松吸入反应优于E型患者。

Objective To evaluate the efficacy of salmeterol/fluticasone inhalation in patients with chronic obstructive pulmonary disease（COPD） with different radio logic phenotypes.Methods The diagnosis of COPD was based on diagnositic and treatment guide in GOLD（Revised 2011）.The chest high-resolution CT scans（HRCT） were performed in 91 COPD patients with grade C and D.The disease was classified into different phenotype according to the HRCT findings：phenotype A（n=5）,phenotype E（n=46） and phenotype M（n=40）.Eighty-six stable COPD patients in phenotype E and phenotype M were enrolled in this study.Patients received salmeterol/fluticasone inhalation（50/500｜J g bid）.The lung function test,CAT scores,6 minute walk test（6MWT） were performed at the baseline and 6,12 months after drug administration in two groups.Results The lung function test,CAT scores and 6MWT were improved significantly in both groups 6 and 12 months after treatment;while which were improved more markedly in phenotype M group compared with phenotype E.Conclusion Patients with phenotype M react to salmeterol/fluticasone inhalation is better than phenotype E.