布地奈德福莫特罗粉吸入剂治疗老年COPD患者的临床疗效及对炎性因子和淀粉样蛋白A表达的影响

Effects of budesonide and formoterol powder inhalation on the efficacy inflammatory factors and serum amyloid A in elderly patients with COPD

目的研究布地奈德福莫特罗粉吸入剂连续治疗对老年慢性阻塞性肺疾病(COPD)患者的疗效及对及对炎性因子和淀粉样蛋白A(SAA)表达的影响。方法将112例老年COPD患者以数字法随机分成试验组和常规组,每组各56例。常规组给予西医常规基础治疗,试验组在常规组治疗基础上给予布地奈德福莫特罗粉吸入剂治疗,对比两组疗效及预后情况。结果治疗后,试验组总有效率好于常规组(P<0.01),两组患者动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、氧合指数(OI)及静态肺顺应性(Cst)值均显著升高(P<0.01),血乳酸(Lac)、内源性呼气末正压(PEEPi)、气道阻力(R)值均下降(P<0.01),且治疗后试验组各指标改善均优于常规组(P<0.01);治疗后,两组血清C反应蛋白水平(CRP)、转化因子-β1(TGF-β1)、白细胞介素18(IL-18)及淀粉样蛋白A(SAA)水平较治疗前均下降,且试验组各指标均低于常规组(P<0.01)。治疗后,两组第1秒用力呼气容积(FEV1 pred)及占预计值的比值(FEV1/FVC)较治疗前升高(P<0.01),且试验组治疗后FEV1pred和FEV1/FVC均高于常规组(P<0.01)。结论布地奈德福莫特罗粉吸入剂治疗老年COPD稳定期患者疗效显著,同时可有效调节血气指数、减轻炎症反应、降低SAA表达,安全可靠。

Objective To study the effect of budesonide and formoterol powder inhalation on expression of inflammatory factors and serum amyloid A(SAA)in elderly patients with chronic obstructive pulmonary disease(COPD).Methods 112 elderly patients with COPD were randomly divided into the experimental group and the conventional group,56 cases in each group.The conventional group was given conventional treatment;the experimental group was given budesonide and formoterol inhalation based on the conventional group.The curative effect and prognosis of the two groups were compared.Results After treatment,the total effective rate of the experimental group was better than that of the conventional group(P<0.01);the values of arterial partial pressure of oxygen(PaO_(2)),saturation of oxygen(SaO_(2)),oxygenation index(OI)and static pulmonary compliance(Cst)were increased in the two groups(P<0.01),the values of blood lactic acid(Lac),endogenous positive end expiratory pressure(PEEPi),airway resistance(R)were decreased in the two groups(P<0.01),and the improvement of the each index were better in the experimental group than that of the conventional group(P<0.01);the levels of serum C-reactive protein(CRP),transforming factor-β1(TGF-β1),interleukin-18(IL-18)and serum amyloid A(SAA)were decreased in the two groups;the levels of serum CRP,TGF-β1 and IL-18 were lower in the experimental group than those of the conventional group(P<0.01);forced expiratory volume in the first second(FEV1pred)and its ratio to the expected value(FEV1/FVC)of the two groups were significantly increased(P<0.01);FEV1 pred and FEV1/FVC were significantly higher in the experimental group than those of the conventional group(P<0.01).Conclusion Budesonide formoterol inhaler has significant therapeutic effect on elderly patients with stable COPD.Same as to effectively regulate blood gas index,reduce inflammatory reaction and reduce SAA expression with safe and reliable.