布地奈德联合异丙托溴铵雾化吸入对慢性阻塞性肺疾病患者肺功能、炎症和血气指标的影响

Effects of aerosol inhalation of budesonide and ipratropium bromide on pulmonary function,inflammation and blood gas indexes in patients with chronic obstructive pulmonary disease

目的探讨联合应用布地奈德和异丙托溴铵雾化吸入对慢性阻塞性肺疾病(COPD)患者肺功能、炎症、血气指标的影响。方法将我院2017年5月~2019年7月诊断并收治的92例COPD患者作为研究对象,按照随机数字表法将92例患者分为对照组和研究组,每组46例。在常规对症治疗的基础上,对照组应用布地奈德雾化吸入,而研究组应用布地奈德联合异丙托溴铵雾化吸入。于治疗前后对两组患者的肺功能、炎症、血气指标进行检测和比较。结果治疗前,两组患者的肺功能、炎症以及血气相关指标之间差异无统计学意义(P>0.05);治疗后,两组患者FVC、FEV1、MMEF、PEF以及PaO2、SpO2水平明显升高,IL-6、PCT、CRP、TNF-α以及PaCO2水平明显降低,与同组治疗前比较差异有统计学意义(P<0.05),而两组之间差异也有统计学意义(P<0.05)。结论联合应用布地奈德和异丙托溴铵雾化吸入治疗COPD患者,不仅可以明显改善患者的肺功能和血气指标,而且可以降低炎症反应相关指标水平,疗效显著,值得临床上推广应用。

Objective To explore the effects of aerosol inhalation of budesonide and ipratropium bromide on pulmonary function,inflammation and blood gas indexes in patients with chronic obstructive pulmonary disease(COPD).Methods 92 patients with COPD diagnosed and admitted to our hospital from May 2017 to July 2019 were selected as study subjects.According to the random number table method,the patients were randomly divided into the control group and the study group,with 46 cases in each group.On the basis of conventional symptomatic treatment,the control group received aerosol inhalation of budesonide,while the study group received aerosol inhalation of budesonide and ipratropium bromide.Lung function,inflammation,and blood gas indexes were measured and compared between the two groups before and after treatment.Results Before treatment,there were no significant differences in lung function,inflammation,and blood gas related indexes between the two groups(P>0.05).After treatment,the levels of forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal midexpiratory flow(MMEF),peak expiratory flow(PEF),partial pressure of oxygen(PaO2),and pulse oximeter oxygen saturation(SpO2)in the two groups increased significantly.The levels of interleukin 6(IL-6),procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and partial pressure of carbon dioxide(PaCO2)were significantly reduced,as compared with those before treatment,and the differences were statistically significant(P<0.05),and the differences between the two groups were also statistically significant(P<0.05).Conclusion The application of aerosol inhalation of budesonide and ipratropium bromide can not only significantly improve the lung function and blood gas indexes of patients with COPD,but also reduce the levels of related indexes of inflammatory response.The effect is significant,and it is worthy of clinical promotion and application.