噻托溴铵粉雾剂对稳定期中重度COPD患者血清IL-27水平的影响

Effect of Tiotropium Bromide Powder for Inhalation on Serum IL-27 level in Patients with Moderate to Severe COPD

目的:探讨噻托溴铵治疗慢性阻塞性肺疾病(COPD)的临床疗效及对患者血清中白细胞介素-27(IL-27)水平的影响。方法:将136例COPD稳定期中重度患者随机分为观察组和对照组,对照组给予丙酸氟替卡松气雾剂治疗,观察组在此基础上给予噻托溴铵粉雾剂;评价两组患者治疗3个月后的临床疗效,比较两组患者治疗前后血清IL-27水平及用力肺活量(FVC)、第1秒用力呼气容积(FEV1)及第1秒用力呼吸容积占用力肺活量百分比(FEV1/FVC)肺功能指标的变化;并分析观察组患者血清IL-27水平与三项肺功能指标的相关性。结果:观察组临床治疗总有效率(98.53%)高于对照组(89.71%)差异有统计学意义(P<0.05);与治疗前相比,治疗3个月后,两组患者血清IL-27含量下降,观察组IL-27含量下降水平较对照组更为明显差异有统计学意义(P<0.05);与治疗前相比,两组治疗3个月后肺功能指标均有所改善,观察组3项肺功能指标均高于对照组,差异有统计学意义(P<0.05);观察组血清IL-27含量与FEV1、FEV1/FVC呈负相关(r=-0.611,r=-0.576,P<0.01),与FVC呈正相关(r=0.824,P<0.05)。结论:噻托溴铵治疗COPD可降低患者血清IL-27水平,对改善患者的气道炎症及肺功能具有重要促进作用。

Objective： To investigate the clinical efficacy of Tiotropium Bromide in the treatment of chronic obstructive pulmonary disease （COPD） and its effect on the levels of interleukin-27 （IL-27） in serum of patients with chronic obstructive pulmonary disease （COPD）. Methods： 136 cases of pa- tients with moderate to severe stable COPD were randomly divided into observation group and control group. The control group was given Fluticasone Propionate Aerosol treatment while the observation group was given Tiotropium Bromide powder for inhalation besides fluticasone propionate aerosol treat- ment. Three months after treatment, the clinical efficacy of two groups was evaluated. Two groups were compared before and after treatment in terms of following of pulmonary function indexes, including the serum level of IL-27, forced vital capacity （ FVC）, 1 s, second forced expiratory volume （ FEV1 ） and the percentage of 1st second forced expiratory volume accounting for forced vital capacity （FEV1/ FVC）. The correlation between the level of serum IL-27 in observation group and three pulmonary function indexes was observed and analyzed. Results： The clinical treatment efficacy of observation group （98.53%）, significantly higher than that of the control group （89.71%, P 〈0. 05） ; Corn-pared with before treatment, after 3 months treatment, the sermn 1L-27 levels of the patients in the two groups decreased, and the level of IL-27 in the observation group was significantly lower than that in the control group （P 〈 0.05 ） ; Compared with before treatment, pulmonary function were improved af- ter 3 months treatment, and FVC, FEV1 and FEVI/FVC levels in the observation group were signifi- cantly higher than those of the control group （P 〈 O. 05 ）. The serum IL-27 level of the observation group was negatively correlated with FEV1 and FEV1/FVC （r =-0. 611, r =-0. 576, P 〈0. O1 ） , hut was positively correlated with FVC （ r = O. 824, P 〈 0.05 ）. Conclusion ： Tiotropium Bromide treatment of COPD can reduce the level of serum IL-27, and improve airway inflammation and pulmonary func- tion.