噻托溴铵联合布地奈德福莫特罗对COPD患者肺部炎性反应及肺功能的影响

Effect of Tiotropium Bromide Combined with Budesonide Formoterol on Pulmonary Inflammation and Pulmonary Function in Patients with COPD

目的探讨噻托溴铵联合布地奈德福莫特罗治疗慢性阻塞性肺疾病(COPD)的临床效果及对患者肺功能的影响。方法选取2018年6月至2020年6月于我院就诊的COPD患者86例,按随机数表法分为两组,各43例。两组均予以常规治疗,对照组吸入噻托溴铵治疗,观察组加用布地奈德福莫特罗治疗。比较两组的肺部炎性反应、肺功能、血气分析指标、6 min步行距离及不良反应发生情况。结果治疗后,观察组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平为(75.32±7.24)ng/L、(12.05±1.62)ng/L、(14.31±1.79)ng/L,低于对照组的(81.63±7.56)ng/L、(14.79±1.87)ng/L、(17.69±2.34)ng/L,差异有统计学意义(P<0.05);治疗后,观察组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV_(1)/FVC为(1.95±0.41)L、(3.15±0.48)L、(65.47±4.58)%,高于对照组的(1.67±0.36)L、(2.87±0.45)L、(59.82±4.53)%,差异有统计学意义(P<0.05);观察组治疗后PaO_(2)为(86.52±7.14)mm Hg,高于对照组的(80.04±7.06)mm Hg,PaCO_(2)为(30.25±4.11)mm Hg,低于对照组的(36.53±4.17)mm Hg,差异有统计学意义(P<0.05);观察组6 min步行距离为(357.52±21.96)m,长于对照组的(324.74±18.53)m,差异有统计学意义(P<0.05);两组不良反应相对轻微,无须处理即可自行消退。结论噻托溴铵联合布地奈德福莫特罗可增强COPD患者的肺功能,提高动脉PaO_(2),减轻肺部炎症损伤,延长6 min步行距离,安全可靠。

Objective To investigate the clinical effect of tiotropium bromide combined with budesonide formoterol in the treatment of chronic obstructive pulmonary disease(COPD)and its influence on patients'lung function.Methods A total of 86 COPD patients in our hospital from June 2018 to June 2020 were selected and divided into two groups according to the random number table method,with 43 cases in each group.Both groups received conventional treatment,the control group was treated with inhaled tiotropium bromide,and the observation group was treated with budesonide formoterol.The pulmonary inflammation,lung function,blood gas analysis index,6-min walking distance and occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the observation group were(75.32±7.24)ng/L,(12.05±1.62)ng/L,(14.31±1.79)ng/L,lower than the control group(81.63±7.56)ng/L,(14.79±1.87)ng/L,(17.69±2.34)ng/L,there were statistical differences(P<0.05).After treatment,the forced expiratory volume(FEV_(1)),forced vital capacity(FVC),FEV1/FVC in the first second of the observation group were(1.95±0.41)L,(3.15±0.48)L,(65.47±4.58)%,higher than the control group(1.67±0.36)L,(2.87±0.45)L,(59.82±4.53)%,statistically significant(P<0.05).The PaO_(2) of the observation group after treatment was(86.52±7.14)mm Hg,higher than the control group(80.04±7.06)mm Hg,PaCO_(2) was(30.25±4.11)mm Hg,lower than the control group(36.53±4.17)mm Hg,there was a statistical difference(P<0.05).The observation group 6 min walking distance is(357.52±21.96)m,which was longer than(324.74±18.53)m in the control group,with statistical difference(P<0.05).The adverse reactions of the two groups are relatively mild,and they can subside without treatment.Conclusion Tiotropium bromide combined with budesonide formoterol can enhance the lung function of patients with COPD,increase arterial PaO_(2),reduce pulmonary inflammation,and extend the walking distance of 6 minutes,which is safe and reliable.