噻托溴铵联合茶碱治疗慢性阻塞性肺疾病伴阻塞性睡眠呼吸暂停低通气综合征患者的临床效果分析

Clinical analysis of tiotropium bromide combined with theophylline in the treatment of patients with chronic obstructive pulmonary disease combined with obstructive sleep apnea hypopnea syndrome

目的探讨噻托溴铵联合茶碱治疗慢性阻塞性肺疾病(COPD)伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床疗效。方法选取2020年4—8月本院收治的88例COPD伴OSAHS患者作为研究对象,采用随机数字表法分为两组,每组44例。对照组采用茶碱治疗,观察组在对照组基础上加用噻托溴铵治疗,比较两组血气分析指标、肺功能及不良反应发生率。结果治疗前,两组二氧化碳分压(Pa-CO_(2))、氧分压(PaO_(2))、第1秒用力呼气容积占用力呼气量比值(FEV1/FVC)、第1秒用力呼气容积占预计值百分比(FEV1%)比较差异无统计学意义;治疗12周后,观察组PaCO_(2)低于对照组,PaO_(2)、FEV1/FVC和FEV1%均高于对照组,差异有统计学意义(P<0.05)。两组治疗期间不良反应发生率比较差异无统计学意义。结论噻托溴铵联合茶碱治疗COPD伴OSAHS疗效确切,不良反应少,能有效改善患者呼吸状况及肺功能。

Objective To investigate the clinical efficacy of tiotropium bromide combined with theophylline in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 88 pa-tients with COPD combined with OSAHS admitted to our hospital from April to August 2020 were selected as the research subjects,and they were divided into two groups according to random number table method,with 44 cases in each group.The control group was treated with theophylline,and the observation group was treated with tiotropium bromide on the basis of the control group,the blood gas analysis indexes,pulmonary function and incidence of adverse reactions were compared between the two groups.Results Before treatment,there were no significant differences in the partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),ratio of forced expiratory volume in one second/forced expiratory vol-ume(FEV1/FVC)and percentage of forced expiratory volume in one second as a percentage of expected value(FEV1%)between the two groups.Af-ter 12 weeks of treatment,PaCO_(2) in the observation group was lower than that in the control group,while PaO_(2),FEV1/FVC and FEV1%were higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of ad-verse reactions between the two groups.Conclusion Tiotropium bromide combined with theophylline is effective in the treatment of COPD with OSAHS,with fewer adverse reactions,and can effectively improve the respiratory status and pulmonary function of patients.