噻托溴铵联合吸入用布地奈德对COPD患者肺功能、凝血功能及痰细胞学指标的影响

Effects of tiotropium bromide combined with inhaled budesonide suspension on pulmonary function,coagulation function and induced sputum cytology indexes in patients with chronic obstructive pulmonary disease

目的探究噻托溴铵联合吸入用布地奈德混悬液在慢性阻塞性肺疾病(COPD)患者中的应用价值。方法选取2018年2月~2020年2月就诊于焦作市第四人民医院的COPD患者102例,按照随机数字表法分为两组,每组各51例。对照组给予吸入用布地奈德混悬液,观察组在对照组基础上给予噻托溴铵。比较两组治疗前后症状改善情况[慢性阻塞性肺疾病症状评分(CAT)、呼吸困难评分(MRC)]、肺功能[第1秒用力呼气容积(FEV_(1))、FEV_(1)/最大肺活量(FVC)、吸气分数(IC/TIC)]、凝血功能[外周血D-二聚体(D-D)、纤维蛋白原(FIB)]、痰细胞学指标[嗜酸性粒细胞(EOS)、单核-巨噬细胞(MON)、中性粒细胞(NEU)]及不良反应发生率。结果治疗1、3个月后,两组CAT、MRC评分均低于治疗前,且观察组低于对照组;FEV_(1)、FEV_(1)/FVC、IC/TIC较治疗前升高,且观察组较对照组高,差异均有统计学意义(P<0.05);两组治疗1个月、3个月后,两组外周血D-D、FIB、痰EOS、MON、NEU较治疗前降低,且观察组低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较差异无统计意义(P>0.05)。结论噻托溴铵联合吸入用布地奈德混悬液治疗COPD患者可加快症状与肺功能改善,减轻凝血紊乱,且不增加药物不良反应。

ObjectiveTo explore the application value of tiotropium bromide combined with inhaled budesonide suspension in patients with chronic obstructive pulmonary disease(COPD).Methods102 COPD patients in Jiaozuo Fourth People's Hospital from February 2018 to February 2020 were selected and divided into two groups according to random number table,51 cases in each group.The control group was given budesonide suspension for inhalation,and the observation group was given tiotropium bromide on the basis of the control group.The improvement of symptoms[chronic obstructive pulmonary disease symptom(CAT)score,dyspnea(MRC)score],lung function[FEV_(1),FEV_(1)/maximum vital capacity(FVC),inspiratory fraction(IC/TIC)],coagulation function[peripheral blood D-dimer(D-D),fibrinogen]were compared between the two groups before and after treatment(FIB),induced sputum cytological indicators[eosinophils(EOS),mononuclear macrophages(MON),neutrophils(NEU)]and the incidence of adverse reactions.ResultsAfter one month and three months of treatment,CAT and MRC scores in two groups were lower than before treatment,observation group was lower than control group,FEV_(1),FEV_(1)/FVC,IC/TIC were higher than before treatment,observation group was higher than control group(P<0.05).After one month and three months of treatment,peripheral blood D-D,FIB,induced sputum EOS,MON,NEU in two groups were lower than those before treatment,observation group was lower than control group(P<0.05).There was no significant difference in the incidence of adverse reactionsbetween the two groups(P>0.05).ConclusionTiotropium bromide combined with inhaled budesonide suspension in the treatment of COPD patients can accelerate the improvement of symptoms and lung function,but also reduce the coagulation disorders,and do not increase the adverse drug reactions.