噻托溴铵联合糖皮质激素治疗慢性阻塞性肺疾病急性加重期的效果及肺功能的影响

Effects of Tiotropiumbromide Combined with Glucocorticoid on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Andits Influence on Pulmonary Function

目的探究噻托溴铵联合糖皮质激素治疗慢性阻塞性肺疾病(COPD)急性加重期的效果及对肺功能的影响。方法选取2017年10月~2018年10月于我院接受治疗的100例COPD急性加重期患者为受试对象,按照随机数字表法随机分为干预组与对照组各50例。两组患者都予以常规吸氧、抗感染治疗+糖皮质激素(丙酸氟替卡松)治疗,干预组在上述基础上联合噻托溴铵进行治疗。比较两组患者治疗1个月后临床疗效差异,并分析治疗前及治疗1个月后患者肺功能[第一秒呼气容积(FEV1)、用力肺活量(FVC)、两者比值(FEV1/FVC)]以及相关血清生化指标[降钙素原(PCT)、C反应蛋白(CRP)]水平的变化情况。结果治疗1个月后,干预组总有效率明显高于同期对照组(P<0.05);两组患者肺功能(FEV1、FVC、FEV1/FVC)水平均较治疗前显著提升,且干预组明显高于同期对照组(P均<0.05);而两组患者血清PCT、CRP水平均较治疗前显著降低,且干预组明显低于同期对照组(P均<0.05)。结论噻托溴铵联合糖皮质激素疗法能有效缓解慢性阻塞性肺疾病急性加重期的临床症状,以及提高肺功能水平。

Objective Toexplore the effects of tiotropiumbromide combined with glucocorticoid on acute exacerbation of chronic obstructive pulmonary disease(COPD)and its influence on pulmonary function.Methods One hundred patients with acute exacerbation of COPD who were treated in our hospital from October 2017 to October 2018 were selected for the study and were randomly divided into intervention group and control group according to the random number table method,with 50 cases in each group.The two groups were given conventional oxygen uptake,anti-infective therapy+glucocorticoid(fluticasone propionate),and intervention group was combined with tiotropium bromide on the basis of the above.The clinical efficacy in the two groups was compared after 1 month of treatment,and the pulmonary function[forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),the ratio of the two(FEV1/FVC)]and serum biochemical indicators[PCT(procalcitonin),C-reaction protein(CRP)]were analyzedbefore treatment and after 1 month of treatment.Results After 1 month of treatment,the total effective rate of treatment in intervention group was significantly higher than that in control group(P<0.05).The levels of pulmonary function(FEV1,FVC,FEV1/FVC)in the two groups were significantly higher than those before treatment,and the levels in intervention group werehigher than those in control group(all P<0.05).The levels of serum PCT and CRP in the two groups were significantly lower than thosebefore treatment,and the levels in intervention group werelower than those in control group(all P<0.05).Conclusion Tiotropium bromide combined with glucocorticoid therapy can effectively alleviate the clinical symptomsand improve pulmonary function of acute exacerbation of chronic obstructive pulmonary disease.