高压氧联合沙美特罗替卡松粉吸入剂对慢性阻塞性肺病稳定期患者肺功能及血清COX-2、MMP-9水平的影响

Effects of hyperbaric oxygen combined with salmeterol xinafoate and fluticasone propionate powder for inhalation on pulmonary function and serum levels of COX-2 and MMP-9 in patients with stable COPD

目的探讨高压氧(HBO)联合沙美特罗替卡松粉吸入剂(舒利迭)对慢性阻塞性肺病(COPD)稳定期患者肺功能及血清环氧化酶(COX-2)、基质金属蛋白酶-9(MMP-9)水平的影响。方法选取2019年2月至2020年2月商丘市第一人民医院收治的COPD稳定期患者96例,按照随机数字表法分为对照组和观察组,每组48例。对照组给予沙美特罗替卡松粉吸入剂(沙美特罗50μg,丙酸氟替卡松250μg)治疗,观察组在对照组的基础上进行HBO治疗。比较2组患者临床疗效、症状消失时间、治疗前后肺功能情况[1 s用力呼吸容积(FEV1)、FEV/用力肺活量(FVC)及FEV1占预计值的百分比(FEV1/Pred)]及血清COX-2、MMP-9水平。结果观察组总有效率为97.92%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗后,观察组体温恢复、咳嗽消失、肺部啰音消失及白细胞恢复时间均短于对照组,FEV1、FEV/FVC及FEV1/Pred水平明显高于对照组,血清COX-2、MMP-9水平明显低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论HBO联合沙美特罗替卡松粉吸入剂治疗COPD稳定期患者的临床效果显著,能够改善患者肺功能,降低血清中COX-2、MMP-9水平。

Objective To explore the effects of hyperbaric oxygen(HBO)combined with salmeterol xinafoate and fluticasone propionate powder for inhalation(trade name:Seretide)on pulmonary function and serum levels of cyclooxygenase-2(COX-2)and matrix metalloproteinase-9(MMP-9)in patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 96 patients with stable COPD treated in the First People’s Hospital of Shangqiu from February 2019 to February 2020 were selected and randomly divided into control group(n=48)and observation group(n=48)by the random number table method.The control group was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation(50μg salmeterol and 250μg fluticasone propionate),and the observation group was treated with HBO on the basis of the treatment of the control group.The clinical efficacy,symptom disappearance time,pulmonary function measured by forced respiratory volume in one second(FEV1)before and after treatment,the ratio of FEV to forced vital capacity(FEV/FVC)and the ratio of FEV1 to predicted value(FEV1/Pred),and the serum levels COX-2 and MMP-9 were compared between the two groups.Results The total effective rate of the observation group(97.92%)was significantly higher than that of the control group(83.33%),with a statistically significant difference(P<0.05).After treatment,the recovery time of normal body temperature,the disappearance time of cough and lung rale,and the recovery time of leukocytes in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05 or P<0.01).After treatment,the levels of FEV1,the ratios of FEV/FVC and FEV1/Pred in the observation group were significantly higher than those in the control group,while the serum levels of COX-2 and MMP-9 in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).Conclusion HBO combined with salmeterol xinafoate and fluticasone propionate powder for inhalation has significant clinical effects on patients with stable COPD by improving their pulmonary function and reducing their serum levels of COX-2 and MMP-9.