噻托溴铵联合氟伐他汀治疗重度支气管哮喘的疗效观察

The effectiveness of tiotropium bromide combined with fluvastatin in the treatment of severe bronchial asthma

目的:观察重度支气管哮喘患者采用噻托溴铵与氟伐他汀联合治疗的效果。方法:选取2015年6月至2017年6月四川省成都市第六人民医院呼吸内科收治的160例重度支气管哮喘患者,随机分为对照组和研究组,每组80例。对照组采用氟伐他汀治疗,研究组采用氟伐他汀联合噻托溴铵治疗。比较两组治疗后胸闷、咳嗽、心脏症状控制分值、脉压差、临床疗效、治疗后呼气峰值流速(PEF)、1s用力呼气容积/用力肺活量(FEV1/FVC)及痰中嗜酸性粒细胞水平。结果:研究组治疗后胸闷、咳嗽、心脏症状控制分值均低于对照组(均P<0.05)。两组脉压差比较差异无统计学意义(P>0.05)。对照组治疗总有效率为83.75%,显著低于研究组的97.50%(P<0.05)。研究组治疗后PEF、FEV1/FVC显著高于对照组,痰中嗜酸性粒细胞水平低于对照组,两组比较差异有统计学意义(P<0.05)。结论:采用噻托溴铵联合氟伐他汀治疗重度支气管哮喘患者效果显著,有助于胸闷等症状的控制,可能与减轻气道阻力,改善肺功能,减轻呼吸道炎症有关。

Objective:To observe the effect of tiotropium bromide combined with fluvastatin in the treatment of severe bronchial asthma. Methods:A total of 160 patients with severe bronchial asthma treated in our hospital from June 2015 to June 2017 were selected,and randomly divided into a control group and a study group,with 80 cases in each group.The patients in the control group were treated with fluvastatin,and those in the study group were treated with fluvastatin combined with tiotropium bromide.The efficacy,the scores of chest tightness,cough and cardiac symptom control,pulse pressure,peak expiratory flow rate(PEF),forced expiratory volume/forced vital capacity(FEV1/FVC) per second,and eosinophil level in sputum were compared. Results:The scores of chest tightness,cough and cardiac symptom control in the study group were higher than those in the control group( P <0.05).There was no significant difference in pulse pressure between the two groups( P >0.05).The total effective rate of the control group was 83.75%,which was significantly lower than that of the study group(97.50%)( P <0.05).After treatment,the PEF and FEV1/FVC in the study group were higher than those in the control group,while the levels of sputum eosinophils were markedly lower( P <0.05). Conclusion:Tiotropium bromide combined with fluvastatin had significant curative effect in the treatment of severe bronchial asthma.It was helpful for the control of symptoms such as chest tightness,which might be related to the reduction of airway resistance,the improvement of lung function and the attenuation of respiratory inflammation.