小剂量阿奇霉素联合噻托溴铵治疗对老年COPD患者肺功能及运动耐量的影响

Effects of low dose azithromycin combined with tiotropium bromide on pulmonary function and exercise tolerance in elderly patients with COPD

目的探讨小剂量阿奇霉素联合噻托溴铵治疗对老年慢性阻塞性肺疾病(COPD)患者肺功能及运动耐量的影响。方法选择该院2015-01~2016-03收治的100例老年COPD患者作为研究对象,随机分为观察组和对照组,各50例。对照组采用噻托溴铵18μg/粒睡前吸入治疗,观察组在对照组的基础上加用小剂量阿奇霉素0.25 g/d口服,均治疗6个月。比较两组治疗前后的肺功能指标[第一秒用力呼气容积(FEV_1)、第一秒用力肺活量(FVC)、用力呼气容积与用力肺活量比值(FEV_1/FVC)]及呼吸困难评分和6 min步行试验。结果治疗后观察组FEV_1、FVC、FEV_1/FVC水平均显著高于对照组,差异有统计学意义(P<0.01)。与对照组相比,观察组呼吸困难评分降低,6 min步行试验行走距离延长,差异有统计学意义(P<0.01)。结论老年COPD采用小剂量阿奇霉素联合噻托溴铵治疗效果显著,可明显改善患者的肺功能及运动耐量,有利于提高患者的生活质量,值得临床推广应用。

Objective To investigate the effect of low dose azithromycin combined with tiotropium bromide on pulmonary function and exercise tolerance in elderly patients with chronic obstructive pulmonary disease（ COPD）.Methods 100 elderly patients with COPD were randomly divided into the observation group（ n = 50） and the control group（ n = 50）. The control group was treated with tiotropium bromide 18 μg per night before sleep. The observation group received the same treatment as the control group plus a small dose of azithromycin 0. 25 g per day orally. Both of the two groups were treated for 6 months. The pulmonary function parameters[including forced expiratory volume（ FEV1）,forced vital capacity（ FVC）,forced expiratory volume and forced vital capacity ratio（ FEV1/FVC） ] and respiratory rate were compared between the two groups before and after the treatment. Results After the treatment,the levels of FEV1,FVC and FEV1/FVC in the observation group were significantly higher than those in the control group（ P 0. 01）. The scores of dyspnea were less,and the walking distance in walk test was longer in the observation group than those in the control group（ P 0. 01）. Conclusion A small dose of azithromycin combined with tiotropium bromide is effective in the treatment of COPD in the elderly patients. It can significantly improve the lung function and exercise tolerance and improve the quality of life for the patients.