信必可都保联合噻托溴铵对AECOPD患者PCT、TIMP-1、MMP-9、IFN-γ、动脉血气及肺功能水平的影响

Effects of symbicort turbuhaler combined with tiotropium bromide on serum PCT,TIMP-1,MMP-9,IFN-γ,arterial blood gases and pulmonary function in patients with AECOPD

目的:探讨信必可都保联合噻托溴铵对急性加重期慢性阻塞性肺疾病(AECOPD)患者血清降钙素原(PCT)、金属蛋白酶-1组织抑制因子(TIMP-1)、基质金属蛋白酶-9(MMP-9)、γ干扰素(IFN-γ)、动脉血气及肺功能水平的影响。方法:选择我院收治的90例AECOPD患者,随机分为对照组和实验组各45例。对照组给予噻托溴铵治疗,实验组给予信必可都保联合噻托溴铵治疗,两组患者均连续给予治疗14d。检测并比较两组患者治疗前后血清PCT、TIMP-1、MMP-9、IFN-γ水平及动脉血氧分压(PaO_2)、动脉血氧饱和度(SaO_2)、动脉血二氧化碳分压(PaCO_2)、肺动脉压(MPAP)、肺动脉收缩压(PASP)、肺动脉舒张压(PADP)。结果:两组治疗前的血清PCT、TIMP-1、MMP-9及IFN-γ水平比较,差异均无统计学意义(P>0.05);两组治疗后的血清PCT、TIMP-1、MMP-9及IFN-γ水平相比治疗前均较低,且实验组治疗后血清PCT、TIMP-1、MMP-9及IFN-γ水平变化均优于对照组,差异均具有统计学意义(P<0.05)。两组治疗前PaO_2、SaO_2、PaCO_2、MPAP、PASP及PADP比较,差异均无统计学意义(P>0.05);两组治疗后PaO_2和SaO_2相比于治疗前明显增大、PaCO_2、MPAP、PASP及PADP明显减小,且实验组治疗后的以上各指标的变化程度均大于对照组,差异均具有统计学意义(P<0.05)。结论:信必可都保联合噻托溴铵能够明显降低AECOPD患者血清PCT、TIMP-1、MMP-9及IFN-γ水平,降低肺动脉高压、改善肺组织氧供,改善患者心肺功能,值得在临床上推广应用。

Objective：To study the effects of symbicort turbuhaler combined with tiotropium bromide on serum PCT,TIMP-1,MMP-9,IFN-γ,arterial blood gases and pulmonary function in patients with AECOPD.Methods：A total of 90 patients in our hospital with AECOPD during January 2014 to January 2017 were divided into the control group（n=45）and the treatment group（n=45）randomly.The control group were treated with tiotropium bromide,the treatment group were treated with symbicort turbuhaler combined with tiotropium bromide.The two groups were treated for 14 days.That was compared of the serum PCT,TIMP-1,MMP-9,IFN-γ,PaO2,SaO2,PaCO2,MPAP,PASP and PADP of the two groups before and after treatment.Results：The serum PCT,TIMP-1,MMP-9,IFN-γ,PaO2,SaO2,PaCO2,MPAP,PASP and PADP of the two groups before treatment have no significantly differences（P〉0.05）.The serum PCT,TIMP-1,MMP-9 and IFN-γlevels of the two groups after treatment were significantly lower than before treatment（P〈0.05）.The serum PCT,TIMP-1,MMP-9 and IFN-γlevels of the treatment group after treatment were significantly lower than the control group（P〈0.05）.The PaO2,SaO2 of the two groups after treatment were significantly higher than before treatment（P〈0.05）,the PaCO2,MPAP,PASP and PADP of the two groups after treatment were significantly lower than before treatment（P〈0.05）.The PaO2,SaO2,PaCO2,MPAP,PASP and PADP of the treatment group after treatment were significantly better than the control group（P〈0.05）.Conclusion：Symbicort turbuhaler combined with tiotropium bromide can reduce the serum PCT,TIMP-1,MMP-9,IFN-γlevels and the pulmonary arterial hypertension,improve the lung tissue oxygen supply and the cardiopulmonary function,and it was worthy clinical application.