噻托溴铵转换方案对既往接受ICS/LABA治疗老年COPD患者预后的影响

Influence of tiotropium bromide on COPD elderly patients who received ICS/LABA

目的探讨噻托溴铵转换方案对既往接受ICS/LABA治疗老年COPD患者预后的影响。方法回顾性分析我院2017年1月-2019年11月收治的GOLD肺功能分级3~4级老年COPD患者共126例的临床资料,均接受过ICS/LABA治疗,其中70例继续采用ICS/LABA治疗方案设为对照组,另56例转换为噻托溴铵治疗设为观察组。比较两组治疗前及治疗后FEV1、FVC、CAT评分、急性加重入院情况及不良反应发生情况。结果观察组治疗后FEV1和FVC水平均显著高于对照组[(1.14±0.18)L vs(1.03±0.16)L,(2.82±0.52)%vs(2.54±0.40)%,P<0.05];观察组治疗后CAT评分显著低于对照组、治疗前[(18.77±3.82)分vs(20.35±4.92)分,(18.77±3.82)分vs(21.62±6.60)分,P<0.05];观察组急性加重入院1次和≥2次比例均显著低于对照组(17.86%vs 30.00%,1.78%vs 8.57%,P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论噻托溴铵转换方案用于既往接受ICS/LABA治疗GOLD肺功能分级3~4级老年COPD患者可有效改善肺通气功能,且安全性良好。

Objective To investigate the influence of tiotropium bromide on COPD elderly patients with GOLD 3~4 grade who received ICS/LABA.Methods 126 COPD elderly patients with GOLD 3~4 grade who received ICS/LABA were retrospectively chosen from January 2017 to November 2019 in our hospital and were divided into 2 groups including control group(70 patients)with ICS/LABA continually used and experiment group(56 patients)with tiotropium bromide,and the levels of FEV1,FVC and CAT were compared between the two groups before and after treatment.Acute aggravation situation and adverse reactions occurrence of the two groups were also compared.Results The levels of FEV1 and FVC of experiment group were significantly higher than those of control group after treatment[(1.14±0.18)L vs(1.03±0.16)L,(2.82±0.52)%vs(2.54±0.40)%,P<0.05].CAT scores of experiment group were significantly less than those of control group after treatment and before treatment[(18.77±3.82)points vs(20.35±4.92)points,(18.77±3.82)points vs(21.62±6.60)points,P<0.05].The proportion of acute exacerbation of admission 1 time and≥2 times of observation group were significantly lower than those of control group[17.86%vs 30.00%,1.78%vs 8.57%,P<0.05].There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Tiotropium bromide can efficiently improve pulmonary ventilation function of COPD elderly patients with GOLD 3~4 who received ICS/LABA and has satisfactory safety.