噻托溴铵联合布地奈德福莫特罗对ACO患者气道重塑及免疫炎性反应的影响

Impacts of tiotropium bromide combined with budesonide formoterol on airway remodeling and immune inflammatory response in patients with ACO

目的探讨噻托溴铵联合布地奈德福莫特罗对哮喘-慢阻肺重叠(ACO)患者气道重塑及免疫炎性反应的影响。方法回顾性选取2020年4月至2021年4月九江市第一人民医院呼吸内科ACO患者89例,采用随机数字表法将其分为对照组(44例)、观察组(45例),对照组在常规治疗基础上,给予布地奈德福莫特罗吸入粉雾剂治疗,观察组在对照组治疗基础上,采用噻托溴铵联合布地奈德福莫特罗治疗,统计分析两组患者的临床疗效、血清气道重塑指标水平、血清免疫炎性相关指标水平、免疫功能、不良反应发生情况。结果观察组患者治疗的总有效率为97.80%(44/45),显著高于对照组的84.10%(37/44)(P<0.05)。观察组患者治疗后较治疗前的血清MMP-9、TGF-β、PCⅢ水平降低幅度均显著高于对照组(P<0.05)。观察组患者治疗后较治疗前的血清TNF-α、IL-6水平降低幅度、Th1、Th2升高幅度均显著高于对照组(P<0.05)。观察组和对照组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论ACO治疗中噻托溴铵联合布地奈德福莫特罗治疗较单独布地奈德福莫特罗治疗更能有效降低患者气道重塑及免疫炎性反应。

Objective To explore the impacts of tiotropium bromide combined with budesonide formoterol treatment on airway remodeling and immune inflammatory response in ACO treatment.Methods A total of 89 patients with ACO admitted to the department of respiratory medicine,Jiujiang NO.1 People’s Hospital,from April 2020 to April 2021 were retrospectively selected and divided into the control(44 patients)and observation(45 patients)groups by a random number table method.The control group was treated with budesonide formoterol fumarate powder for inhalation based on the conventional treatment.The observation group was treated with tiotropium bromide combined with budesonide formoterol based on the control group’s treatment.The clinical efficacy,the levels of serum airway remodeling indexes,the levels of serum immune inflammatory related indexes,immune function,and the occurrence of adverse reactions in the two groups were statistically analyzed.Results The total effective rate of treatment in the observation group was 97.80%(44/45),which was significantly higher than 84.10%(37/44)in the control group(P<0.05).The reductions of serum MMP-9,TGF-β,PCⅢ levels after treatment compared with before treatment were all significantly higher in observation group than those in the control group(P<0.05).The reductions of TNF-α,IL-6 level and the increases of Th1 and Th2 after treatment compared with before treatment were significantly higher than those in the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion In ACO treatment,tiotropium bromide combined with budesonide formoterol is more effective in reducing airway remodeling and immune inflammatory response in patients than budesonide formoterol alone.