布地奈德福莫特罗联合噻托溴铵对慢性阻塞性肺疾病患者的临床疗效及血清COX-2、PLA-2水平的影响

Effects of budesonide formoterol combined with tiotropium bromide on the clinical efficacy,serum COX-2 and PLA-2 levels in patients with chronic obstructive pulmonary disease

目的研究布地奈德福莫特罗联合噻托溴铵对慢性阻塞性肺疾病患者的临床疗效及炎症因子的影响。方法选取的研究对象为2015-05至2016-05于本院治疗的84例慢性阻塞性肺疾病(Chronic Obstructive Pulmoriary Disease,COPD)患者,按照随机数字表法平均分成对照组和观察组,各42例。对照组在常规治疗基础上给予噻托溴铵吸入粉雾剂治疗,观察组在对照组基础上联合应用布地奈德福莫特罗粉吸入剂治疗。治疗8周后,对比两组患者的临床疗效、改良英国医学研究学会呼吸困难指数(modified british medical research council,mMRC)评分、6 min步行距离(6-minute walk distance,6MWD)、动脉血气值包括动脉血氧分压(partial pressure of oxygen in arterial blood,PaO2)、动脉血二氧化碳分压(arterial blood partial pressure of carbon dioxide,PaCO2)、肺功能包括第一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1占用力肺活量(Forced Vital Capacity,FVC)百分比(FEV1/FVC)、功能残气量(Functional residual capacity,FRC)、深吸气量(Inspiratory Capacity,IC)及血清中环氧合酶2(cyclooxygenase-2,COX-2)、磷脂酶A2(phospholipaseA2,PLA2)水平。结果与治疗前相比,治疗后两组患者的mMRC、PaCO2、FRC、COX-2、PLA-2水平均降低,6MWD、PaO2、FEV1、FEV1/FVC、IC水平均升高(P<0.05)。与治疗后对照组相比,治疗后观察组患者的mMRC、PaCO2、FRC、血清COX-2、PLA-2水平均较低(P<0.05),治疗总有效率、6MWD、PaO2、FEV1、FEV1/FVC、IC水平均较高(P<0.05)。结论布地奈德福莫特罗联合噻托溴铵治疗慢性阻塞性肺疾病患者可提高临床疗效,降低患者mMRC评分、有效改善肺功能,提高生活质量,降低炎症反应。

Objective To study the effects of budesonide formoterol combined with tiotropium bromide on the clinical efficacy and inflammatory factors in patients with chronic obstructive pulmonary disease.Methods A total of 84 patients with Chronic Obstructive Pulmonary Disease(COPD)treated in our hospital from May 2015 to May 2016 were selected and they divided into a control group and an observation group according to the random number table method,with 42 cases each.The control group was treated with tiotropium bromide inhalation powder adding to the conventional treatment,and the observation group was treated with budesonide formoterol powder inhalation adding to the control group.After 8 weeks of treatment,the clinical efficacy,the mMRC score,the 6-minute walk distance(6MWD),the blood gas[PaO2、PaCO2],the lung function[forced expiratory volume in 1 second(FEV1),FEV1/FVC,functional residual capacity(FRC),inspiratory capacity(IC)],cyclooxygenase-2(COX-2)and phospholipase A2(PLA-2)levels were compared between the two groups.Results Compared with before treatment,the levels of mMRC,PaCO2,FRC,COX-2,and PLA-2 decreased,while the levels of 6MWD,PaO2,FEV1,FEV1/FVC,and IC increased in both groups(P<0.05).Compared with the control group after treatment,the levels of mMRC,PaCO2,FRC,serum COX-2,and PLA-2 were lower in the observation group(P<0.05),while the levels of total effective rate,6MWD,PaO2,FEV1,FEV1/FVC,and IC were higher(P<0.05).Conclusion The use of budesonide formoterol combined with tiotropium bromide in patients with chronic obstructive pulmonary disease can improve clinical efficacy,reduce mMRC score,effectively improve lung function and quality of life,and reduce inflammatory responses.