布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期的临床观察

Clinical Observation on Budesonide Formoterol Combined with Tiotropium Bromide in Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的分析布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期的临床疗效。方法选取2015年2月-2016年9月收治的慢性阻塞性肺疾病急性加重期患者70例,将所有患者随机分为两组,各35例。对照组采用雾化吸入布地奈德福莫特罗治疗,观察组在对照组治疗的基础上加用噻托溴铵治疗,比较两组诱因、治疗前后肺功能、动脉血气及血清中血清C反应蛋白、血清降钙素原、白细胞计数水平、不良反应发生率。结果两组患者在慢性阻塞性肺疾病急性加重期诱因构成比比较中无显著性差异(P>0.05);治疗前,两组患者FEV_1、FVC、FEV_1占预计值百分比、PaCO_2、PaO_2、血清C反应蛋白、血清降钙素原、白细胞计数比较无显著性差异(P>0.05);治疗后,观察组FEV_1、FVC、FEV_1占预计值百分比、PaCO_2、血清C反应蛋白、血清降钙素原、白细胞计数水平低于对照组,PaO_2高于对照组,有显著性差异(P<0.05);两组不良反应发生率比较无显著性差异(P>0.05)。结论布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病急性加重期临床效果显著,可有效改善患者肺功能状态,控制炎症,提高患者自身的免疫力,具有较高的临床价值,在临床应用中值得推广。

Objective To analyze the clinical efficacy of budesonide formoterol combined with tiotropium bromide in treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods 70 AECOPD patients ad- mitted into our hospital from February 2015 to September 2016 were randomly divided into two groups, 35 cases in each. Control group took aerosol inhalation of budesonide formoterol, and observation group took tiotropium bromide on the basis of control group. The incentives, lung function, arterial blood gas （ABG）, serum C reactive protein, procalcitonin, white blood cell count levels in serum, incidence of adverse reactions of two groups were compared. Results There was no significant difference in the constitution ratio of incentives of AECOPD between the two groups （ P 〉 0.05 ） ; Before treatment, there was no significant difference in the lung function, ABG, serum C - reactive protein, procalcitonin, white blood cell count between the two groups （ P 〉 0.05 ） ; After treatment, the lung function and improvement of arterial blood gas in observation group were better than control group, and the serum C - reactive protein, procalcitonin, white blood cell count were lower than con- trol group （ P 〈 0.05 ） ; There was no significant difference in the incidence of adverse reactions between the two groups （ P 〉 0.05 ）. Conclusion Budesonide formoterol combined with tiotropium bromide for treating AECOPD has significant clinical effects. It can effectively improve status of lung function, control inflammation and increase immunity, which has higher clini- cal value and is worthy of generalization in clinical application.