异丙托溴铵气雾剂吸入治疗对支气管哮喘患者气道重塑的影响

Effect of Ipratropium Bromide Aerosol Inhalation on Airway Remodeling in Patients with Bronchial Asthma

目的:探究丙托溴铵气雾剂吸入治疗对支气管哮喘患者气道重塑的影响。方法:选取2018年7月~2019年7月本院收治的支气管哮喘患者80例,,随机数表法分为观察组(n=43)和对照组(n=37)。所有患者均接受常规对症治疗,在此基础上对照组接受布地奈德雾化吸入治疗,观察组接受布地奈德+异丙托溴铵气雾剂吸入治疗,比较两组患者的临床症状改善情况,治疗前后肺功能、气道重塑指标和炎症因子水平变化,记录患者治疗后6个月的支气管哮喘复发情况。结果:观察组的咳嗽缓解、胸闷缓解和肺部啰音改善时间均明显短于对照组;治疗后,观察组患者的第1秒用力呼气量(FEV1)、用力呼气量占用力肺活量的比值(FEV1/FVC)和最大呼气流速(PEF)水平高于对照组,支气管总面积(TA)、管壁面积(WA)和管腔面积(LA)小于对照组,血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)水平低于对照组;随访期间,观察组患者的支气管哮喘复发率明显低于对照组(6.28% vs.27.03%);治疗期间,两组患者均未出现药物相关不良反应。结论:异丙托溴铵气雾剂吸入治疗可明显改善支气管哮喘患者的临床症状,提高患者肺功能,降低气道重塑和炎症因子水平,且复发率低,安全性较好。

Objective To investigate the effect of ipratropium bromide aerosol inhalation on airway remodeling in patients with bronchial asthma.Methods Between July 2018 and July 2019,80 patients with bronchial asthma were selected and randomly divided into observation group (n=43) and control group (n=37).All patients received conventional symptomatic treatment.On this basis,the control group received budesonide aerosol inhalation,and the observation group received budesonide combined with ipratropium bromide aerosol inhalation.The improvement of clinical symptoms,changes in lung function,airway remodeling indicators,and inflammatory factors before and after treatment were compared between the two groups.The recurrence of bronchial asthma in 6 months after treatment was recorded.Results The cough relief time,chest tightness relief time and lung rale improvement time in the observation group were significantly shorter than those in the control group (P<0.05).After treatment,the forced expiratory volume in 1s (FEV1),the forced expiration volume in 1s to forced vital capacity ratio (FEV1/FVC) and peak expiratory flow (PEF) of the observation group were higher than those of the control group,while the total bronchial area (TA),wall area (WA),lumen area (LA),levels of serum interleukin-6(IL-6),tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were smaller and lower than those in the control group.During follow-up,the recurrence rate of bronchial asthma in the observation group was significantly lower than that in the control group (6.28% vs.27.03%).No drug-related adverse reactions were observed in the two groups.Conclusion Ipratropium bromide aerosol inhalation can significantly improve the clinical symptoms in patients with bronchial asthma,improve their lung function,and reduce airway remodeling and inflammatory factors,with a low recurrence rate and good safety.