噻托溴铵对老年COPD稳定期患者肺功能、血气参数和炎症因子的影响

Effect of tiotropium bromide on pulmonary function,arterial blood gas and serum inflammatory cytokine in elderly patients with COPD at stable stage

目的:观察噻托溴铵对老年慢性阻塞性肺病(COPD)稳定期患者肺功能、血气参数的影响。方法:80例老年COPD稳定期患者依据随机数据表法分为治疗组和对照组。对照组依据常规治疗,治疗组在常规治疗基础上增加噻托溴铵干粉吸入治疗。治疗1个月后,比较两组肺功能指标、血气指标及炎症因子指标变化。结果:治疗前两组患者的肺功能指标、:肿瘤坏死因子-α(TNF-α)水平比较无显著性差异(P>0.05);治疗后,两组的肺功能指标FVC、FEV1%、PEF显著上升,血清中TNF-α水平显著下降(P<0.05),且治疗组优于对照组(P<0.05)。治疗前,两组老年COPD稳定期患者的血气指标比较无显著性差异(P>0.05);治疗后,对照组PaO_2、PaCO_2、PaO_2/FiO_2和血清PCT水平变化不明显,而治疗组PaO_2和PaO_2/FiO_2水平显著上升,PaCO_2和血清中PCT显著降低(P<0.05),且治疗组优于对照组(P<0.05)。结论:噻托溴铵治疗可改善老年COPD稳定期患者的肺功能、血气参数,减轻了炎症,提高了治疗疗效。

Objective： To observe the clinical effect of tiotropium bromide on pulmonary function, blood and serum inflammatory cytokine in elderly patients with COPD at stable stage. Methods： A total of 80elderly patients with COPD at stable stage were randomly divided into treatment group and control group, with 40 cases in each group. The control group was treated with conventional treatment, the treatment group was treated with tiotropium bromide on the basis of control group. One month after treatment, the pulmonary function, arterial blood gas and serum inflammatory cytokine were detected and compared in the two groups. Results： There was no significant difference in lung function indexes and TNF- alpha level between the two groups before treatment （ P 〉0.05）. The levels of FVC, FEV1% and PEF were increased and serum TNF-α was decreased significantly after treatment in two groups（ P 〈0.05）, and they were more obvious in treatment group than those in control group （all P 〈0.05）; There was no significant difference in blood gas indexes between the two groups before treatment （ P 〉 0.05）; in addition, there were no significant difference in the level of PCT, PaO 2, PaCO 2 and PaO 2/FiO 2 after treatment in control group, but the level of PCT and PaCO 2 were higher, and PaO 2 and PaO 2/FiO 2 were lower significantly in treatment group after treatment（ P 〈0.01）. The treatment group was superior to the control group （all P 〈0.05）.Conclusion： Tiotropium bromide can improve pulmonary function, pulmonary function, arterial blood gas and serum inflammatory cytokine in elderly stable COPD patients.