氨茶碱与糖皮质激素药物对慢性阻塞性肺疾病缓解期患者运动耐力及肺功能的影响

Effect of aminophylline and glucocorticoids on exercise endurance and pulmonary function of patients with chronic obstructive pulmonary disease in remission stage

目的研究氨茶碱与糖皮质激素药物对慢性阻塞性肺疾病(COPD)缓解期患者运动耐力与肺功能的影响。方法100例COPD缓解期患者作为研究对象,随机分为观察组和对照组,各50例。对照组应用布地奈德雾化吸入治疗,观察组在对照组基础上联合氨茶碱小剂量治疗。比较两组临床疗效及治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、第一秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)]及6 min步行距离(6MWD)。结果观察组治疗总有效率92.0%高于对照组的76.0%,差异有统计学意义(P<0.05)。治疗后,观察组FEV1(1.80±0.42)L、FEV1%(78.95±2.14)%、FEV1/FVC(64.80±5.30)%均高于对照组的(1.46±0.25)L、(64.21±4.21)%、(55.47±4.21)%,差异有统计学意义(P<0.05)。治疗后,观察组6WMD(289.67±38.64)m显著长于对照组的(225.61±32.48)m,差异有统计学意义(P<0.05)。结论COPD缓解期联合使用氨茶碱与糖皮质激素药物治疗可改善患者肺功能指标,缓解患者运动受限症状,值得在临床推广。

Objective To study the effect of aminophylline and glucocorticoids on exercise endurance and pulmonary function of patients with chronic obstructive pulmonary disease(COPD)in remission stage.Methods A total of 100 patients with COPD in remission stage were selected as the study subjects,and were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated with budesonide aerosol inhalation,and the observation group was treated with low-dose aminophylline on the basis of the control group.Both groups were compared in terms of clinical efficacy,and the pulmonary function indexes[forced expiratory volume in one second(FEV1),FEV1 as a percentage of the predicted value(FEV1%),the ratio of FEV1 to forced vital capacity(FEV1/FVC)]and 6 min walking distance(6MWD)before and after treatment.Results The total effective rate of 92.0%in the observation group was higher than that of 76.0%in the control group,and the difference was statistically significant(P<0.05).After treatment,the observation group had FEV1 of(1.80±0.42)L,FEV1 of(78.95±2.14)%and FEV1/FVC of(64.80±5.30)%,which were higher than those of(1.46±0.25)L,(64.21±4.21)%and(55.47±4.21)%in the control group,and the differences were statistically significant(P<0.05).After treatment,the 6WMD of(289.67±38.64)m in the observation group was significantly longer than that of(225.61±32.48)m in the control group,and the differences were statistically significant(P<0.05).Conclusion For patients with COPD in remission stage,the combination of aminophylline and glucocorticoids can improve pulmonary function indicators and alleviate patients'symptoms of exercise limitation,and is worthy of clinical promotion.