噻托溴铵联合布地奈德福莫特罗对慢性阻塞性肺疾病的疗效及对TGF-β、TIMP-1、IL-6水平的影响

Clinical Efficacy of Tiotropium Bromide Combine With Budesonide and Formoterol in the Treatment of Chronic Obstructive Pulmonary Disease and its Effects on Levels of TGF-β, TIMP-1 and IL-6

目的:探讨噻托溴铵联合布地奈德福莫特罗治疗慢性阻塞性肺疾病(COPD)患者的临床疗效及对转化生长因子-β(TGF-β)、基质金属蛋白酶抑制因子-1(TIMP-1)及白细胞介素-6(IL-6)水平的影响。方法:选取我院于2016年1月至2016年12月期间收治的80例稳定期的COPD患者,按乱数表法分为对照组和观察组,两组均为40例。两组患者均进行常规治疗和布地奈德福莫特罗吸入治疗,观察组在此基础上加用噻托溴铵吸入剂。连续治疗12周后对两组患者的临床疗效、肺功能、血气指标、细胞因子水平进行评价。结果:观察组患者总有效率高于对照组(P<0.05)。治疗后,观察组肺功能指标用力肺活量(FVC)、一秒用力呼气容积(FEV1)、第一秒用力呼气容积占用力肺活量比值(FEV1/FVC)、动脉血氧分压(PaO_2)和动脉血二氧化碳分压(PaCO_2)改善程度均优于对照组(P<0.05)。治疗后观察组患者血清中IL-6、TIMP-1及TGF-β水平均低于对照组(P<0.05)。结论:噻托溴铵与布地奈德福莫特罗的联合治疗稳定期的COPD患者疗效显著,并且能够有效改善患者肺功能和血气指标,降低血清TGF-β、TIMP-1及IL-6水平,值得临床推广使用。

Objective： To observe the clinical efficacy of tiotropium bromide combine with budesonide and formoterol in the treatment of chronic obstructive pulmonary disease（COPD） and its effects on levels of Transforming growth factor-β（TGF-β）, Matrix metalloproteinase inhibitor-1（TIMP-1） and Interleukin-6（IL-6）. Methods： 80 patients with stable COPD who were treated in our hospital from January 2016 to December 2016 were selected, the patients were divided into observation group and control group according to the random number table method, 40 cases in each group. Both groups were treated with conventional treatment and budesonide and formoterol inhalation therapy. On the basis of conventional treatment, the observation group were treated combine of tiotropium bromide.After 12 weeks of continuous treatment, the clinical efficacy, pulmonary function, blood gas index and cytokine levels of the two groups were evaluated. Results： The total effective rate in the observation group was significantly higher than that in the control group（P〈0.05）.After treatment, the lung function index of forced vital capacity（FVC）, Forced expiratory volume in one second（FEV1）, the forced expiratory volume in the first second accounted for the ratio of forced vital capacity（FEV1/FVC）, arterial oxygen pressure（PaO_2） and arterial carbon dioxide pressure（PaCO_2） in the observation group were better than those in the control group（P〈0.05）. The serum levels of TGF-β, TIMP-1 and IL-6 after treatment in the observation group were lower than those in the control group（P〈0.05）. Conclusion：Tiotropium bromide combine with budesonide and formoterol is effective in the treatment of COPD, which can effectively improve the pulmonary function and blood gas in patients, serum TGF-β, TIMP-1 and IL-6 levels are decreased, it is worthy of clinical application.