沙美特罗替卡松联合氨茶碱治疗慢性阻塞性肺疾病急性加重期疗效及对氧化应激反应的影响

Clinical Effect of Salmeterol and Fluticasone Propionate Combined with Aminophylline for Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Its Effect on Oxidative Stress

目的探讨沙美特罗替卡松联合氨茶碱治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效和对氧化应激反应的影响。方法选择医院2014年4月至2016年7月收治的AECOPD患者220例,随机分为对照组和观察组,各110例。两组患者均予以常规治疗,对照组患者加用氨茶碱,治疗5 d;观察组患者在对照组基础上联合沙美特罗替卡松治疗,治疗2周。结果观察组患者治疗总有效率显著高于对照组(95.45%比84.55%,χ~2=8.107,P=0.017);两组患者第1秒用力呼气容积(FEV_1)、第1秒用力呼气容积占用力肺活量的百分比(FEV_1/FVC)均较治疗前升高(P<0.01),且观察组患者各指标改善水平明显优于对照组(P<0.01);治疗后,两组患者丙二醛较治疗前降低(P<0.01),谷胱甘肽过氧化物酶和超氧化物歧化酶均较治疗前升高,且观察组患者上述指标改善明显优于对照组(P<0.01)。结论沙美特罗卡松联合氨茶碱治疗AECOPD,能有效降低氧化应激反应,改善患者肺功能,提高临床疗效,值得临床推广。

Objective To investigate the effect of salmeterol and fluticasone propionate combined with aminophylline for treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its effect on oxidative stress.Methods Totally 220 patients with AECOPD admitted to our hospital from April 2014 to July 2016 were randomly divided into the control group and the observation group,110 cases in each group.The two groups were treated with conventional treatment,on this basis,the control group was treated with aminophylline for 5 d,on the basis of the control group,the observation group was treated with salmeterol and fluticasone propionate for 2 weeks.Results The total effective rate of the observation group was significantly higher than that of the control group(95.4 5%84.5 5%,;X2=8.107,P=0.017).The FEVi and FEVi/FVC of the two groups were higher than those before the treatment P<0.01),and the improvement of the indexes in the observation group were significantly better than those in the control grcup(P<0.01).After treatment,the levels of MDA in the two groups were lower than those before treatment(P<0.01),but the levels of G SH-Px and SOD in the two groups were higher than those before treatment,the improvement of the indexes in the observation group were significantly better than that in the control group(P<0.01).Conclusion Salmeterol and fluticasone propionate combined with aminophylline for treating AECOPD can effectively reduce the reaction of oxidative stress,improve the lung function and the clinical effect.It is worthy of clinical promotion.