不同吸入药物用于中重度稳定期慢性阻塞性肺疾病患者的效果探究

Study on the effect of different inhaled drugs on patients with moderate or severe chronic obstructive pulmonary disease in stable p

目的 探索不同吸入药物对中重度稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的疗效。方法 以2020年7月至2022年7月于我院进行治疗的180例中重度稳定期COPD患者为研究对象,随机分为A、B及C组,每组各60例。A组予以噻托溴铵,B组予以沙美特罗/替卡松,C组予以乌美溴铵/维兰特罗。比较3组患者治疗前后肺功能、血气情况、炎性因子水平及不良事件。结果 干预后,临床有效率A、B、C 3组依次递增,差异有统计学意义(P <0.05);C组患者第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/用力肺活量和FEV1占预计值百分比水平显著高于A、B组(P <0.05),3组患者呼气流量峰值水平无显著差异(P> 0.05);C组患者氧分压和血氧饱和度水平显著高于A、B组,二氧化碳分压水平显著低于A、B组(P <0.05);C组患者白介素(interleukin,IL)-6、IL-8和肿瘤坏死因子-α水平均与B组相当(P> 0.05),且显著低于A组(P <0.05)。干预期间,C组急性发作次数显著低于A、B组(P <0.05),3组间其他不良事件无统计学差异(P> 0.05)。结论 乌美溴铵/维兰特罗可有效改善中重度稳定期COPD患者肺功能和血气指标,降低炎症反应及急性发作风险,且安全性良好。

Objective To explore the clinical effect of different inhaled drugs on patients with moderate or severe chronic obstructive pulmonary disease(COPD)in stable phase.Methods 180 patients with moderate or severe stable COPD treated in our hospital from July 2020 to July 2022 were randomly divided into three groups:A group,B group and C group,and 60 cases in each group.The patients in A group were given tiotropium bromide,the patients in B group were given salmeterol/ticasone,and the patients in C group were treated with umeclidinium bromide/vilanterol trifenatate.Pulmonary function index,blood gas index,level of inflammatory factors and adverse events during intervention were compared before and after treatment among the three groups.Results After intervention,the clinical effective rate of A,B and C group increased successively,and the differences were statistically significant(P<0.05).The levels of forced expiratory volume in one second(FEV1),FEV1%pred and FEV1/forced vital capacity(FVC)in group C were significantly higher than those in A and B group(P<0.05),but there was no significant difference in the level of peak expiratory flow(PEF)among the three groups(P>0.05).The levels of PaO2 and SaO2 in group C were significantly higher than those in A and B group(P<0.05),while the level of PaCO2 in C group was significantly lower than that in A and B group(P<0.05).The levels of IL-6,IL-8 and TNF-α in C group were similar to those in B group(P>0.05) and significantly lower than those in A group(P<0.05). During the intervention period, the number of acute attacks in C group was significantly lower than that in A and B group(P<0.05), but there was no significant difference in adverse events among the three groups(P>0.05). ConclusionUmeclidinium bromide/vilanterol trifenatate can effectively improve pulmonary function and blood gas indexes, reduce inflammatory reaction, reduce the risk of acute attack in patients with moderate or severe stable COPD, with good safety.