布地奈德、沙丁胺醇联合噻托溴铵对老年支气管哮喘血气指标、肺功能及炎症因子的影响

Effects of budesonide, salbutamol combined with tiotropium on blood gas indexes, pulmonary function and inflammatory factors in elderly patients with bronchial asthma

目的探讨布地奈德、沙丁胺醇联合噻托溴铵对老年支气管哮喘患者血气指标、肺功能及炎症因子的影响。方法选取我院2017年1月~2018年6月收治的80例住院老年支气管哮喘患者作为研究对象,按照随机数字表法分为对照组40例和观察组40例,对照组患者给予布地奈德吸入剂(1mg/次,3次/d)治疗,观察组在对照组的基础上给予硫酸沙丁胺醇溶液(1mL/次,3次/d)和噻托溴铵粉吸入剂(18μg/次,2次/d)治疗,比较两组患者症状体征缓解时间及治疗前后血气指标、肺功能指标及炎症因子指标变化情况。结果观察组的气促、胸闷、咳嗽、哮鸣音缓解时间明显短于对照组,差异有统计学意义(P<0.05)。两组治疗后PaO2、SaO2均较治疗前明显升高,差异有统计学意义(P<0.05),PaCO2较治疗前明显降低,差异有统计学意义(P<0.05),观察组治疗后PaO2、SaO2明显高于对照组,差异有统计学意义(P<0.05),PaCO2明显低于对照组,差异有统计学意义(P<0.05)。两组治疗后FEV1、FEV1/FVC比值较治疗前明显升高,差异有统计学意义(P<0.05),PEF昼夜变异率较治疗前明显降低,差异有统计学意义(P<0.05),观察组治疗后FEV1、FEV1/FVC比值明显高于对照组,差异有统计学意义(P<0.05),PEF昼夜变异率明显低于对照组,差异有统计学意义(P<0.05)。两组治疗后CRP、TNF-α、IL-8较治疗前明显降低,差异有统计学意义(P<0.05),观察组治疗后CRP、TNF-α、IL-8明显低于对照组,差异具有统计学意义(P<0.05)。结论布地奈德、沙丁胺醇联合噻托溴铵治疗老年支气管哮喘能够发挥更好的抗炎效果,对血气指标、肺功能的改善作用更显著,缩短了临床症状、体征缓解时间,有效提高了临床治疗效果。

Objective To explore the effects of budesonide, salbutamol combined with tiotropium on blood gas indexes, pulmonary function and inflammatory factors in elderly patients with bronchial asthma. Methods 80 hospitalized elderly patients with bronchial asthma who were admitted and treated in our hospital from January 2017 to June 2018 were selected as research objects. According to the random number table method, they were divided into the control group and the observation group, with 40 cases in each group. Patients in the control group was treated with budesonide inhalant (1 mg/time, 3 times a day). The observation group was given salbutamol sulfate solution (1 mL/time, 1 day 3 times) and tiotropium bromide powder inhalant (18μg/time, 2 times a day) on the basis of the control group. The relief time of symptoms and signs, the changes of blood gas index, lung function index and inflammatory factor index before and after treatment were compared between the two groups. Results The relief time of shortness of breath, chest tightness, cough, wheezing of the observation group, and the difference was statistically significant (P < 0.05). PaO2 and SaO2 of both groups after treatment were significantly higher than those before treatment, and the difference was statistically significant (P < 0.05). PaCO2 of both groups after treatment was significantly lower than that before treatment, and the difference was statistically significant (P < 0.05). PaO2 and SaO2 of the observation group after treatment were significantly higher than those of the control group, and the difference was statistically significant (P < 0.05). PaCO2 was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). The FEV1 and FEV1/FVC of both groups after treatment were significantly higher than those before treatment, and the difference was statistically significant (P < 0.05). The day-night mutation rate of PEF of both groups after treatment was significantly lower than that before treatment, and the difference was statistically significant (P < 0.05). The ratio of FEV1 and FEV1/FVC in the observation group after treatment was significantly higher than that in the control group, and the difference was statistically significant (P < 0.05). The day-night mutation rate of PEF in the observation group after treatment was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). The CRP, TNF-α and IL-8 of both groups after treatment were significantly lower than those before treatment, and the difference was statistically significant (P < 0.05). The CRP, TNF-α and IL-8 in the observation group after treatment were significantly lower than those in the control group, and the difference was statistically significant (P < 0.05). Conclusion Budesonide, salbutamol combined with tiotropium in treatment of elderly patients with bronchial asthma can improve the anti-inflammatory effects, which can significantly improve the blood gas index and pulmonary function, shorten the relief time of clinical symptoms and signs and effectively improve the clinical curative effects.