格隆溴铵福莫特罗吸入气雾剂对慢性阻塞性肺疾病稳定期患者血清TIMP-1、LTB4及动脉血气分析指标的影响

Influence of glycopyrronium bromide formoterol fumarate inhalation aerosol on serum TIMP-1,LTB4 and arterial blood gas indexes in patients with stable chronic obstructive pulmonary disease

目的 探究格隆溴铵福莫特罗吸入气雾剂对慢性阻塞性肺疾病(COPD)稳定期患者血清基质金属蛋白酶抑制剂-1(TIMP-1)、白三烯B4(LTB4)及动脉血气分析指标的影响。方法 按简单随机化分组法将2021年3月至2023年9月建德市第一人民医院就诊的COPD稳定期患者分为观察组和对照组,各45例,观察组采用格隆溴铵福莫特罗吸入气雾剂治疗,对照组采用布地奈德福莫特罗吸入粉雾剂(Ⅱ),两组均持续治疗3个月。比较两组患者的临床疗效、治疗期间的不良反应发生情况和急性发作次数。比较两组患者治疗前和治疗3个月后的肺功能指标、血清TIMP-1、LTB4和动脉血气分析指标。结果 治疗3个月后,观察组的总有效率(93.33%)高于对照组(77.78%)(P<0.05)。两组的不良反应发生率差异无统计学意义(P>0.05);观察组急性发作次数[(0.98±0.12)次]低于对照组[(1.11±0.19)次](P<0.05)。治疗3个月后,两组的第1秒用力呼气容积(FEV_1)、用力肺活量(FVC)、最大呼气流量(PEF)和动脉血氧分压(Pa O_(2))均较治疗前提高,观察组FEV_1、FVC、PEF、Pa O_(2)[分别为(2.88±0.41) L、(3.21±0.33) L、(60.13±5.23) L·min^(-1)、(77.17±2.34) mm Hg(1 mm Hg≈0.133 k Pa)]高于对照组[分别为(2.62±0.43) L、(2.94±0.40) L、(57.27±5.27) L·min^(-1)、(75.51±2.20) mm Hg](P<0.05)。治疗3个月后,两组的血清TIMP-1、LTB4和动脉血二氧化碳分压(Pa CO_(2))均较治疗前降低,观察组TIMP-1、LTB4、Pa CO_(2)[分别为(58.32±4.10)μg·L^(-1)、(106.56±6.79) ng·L^(-1)、(46.58±2.42) mm Hg]低于对照组[分别为(60.97±4.36)μg·L^(-1)、(110.23±7.57) ng·L^(-1)、(48.43±2.46) mm Hg](P<0.05)。结论 格隆溴铵福莫特罗吸入气雾剂治疗COPD稳定期患者具有较好的疗效和安全性,有助于改善患者肺功能指标、血清TIMP-1、LTB4和动脉血气分析指标。

Objective To investigate the influence of glycopyrronium bromide formoterol fumarate inhalation aerosol on serum levels of tissue inhibitor of metalloproteinase-1(TIMP-1),leukotriene B4(LTB4)and arterial blood gas indexes in patients with stable chronic obstructive pulmonary disease(COPD).Methods According to the simple randomization grouping method,the patients with stable COPD admitted to our hospital from March 2021 to September 2023 were divided into the observation group and control group,with 45 patients in each group.The patients in the observation group were treated with glycopyrronium bromide formoterol fumarate inhalation aerosol,and those in the control group with budesonide formoterol inhaled powder inhalation(Ⅱ).All the patients in both groups were continuously treated for 3 months.The clinical efficacy,occurrence of adverse reactions and acute attack frequency during treatment and levels of pulmonary function indexes,serum TIMP-1,LTB4 and arterial blood gas indexes before treatment and after 3 months of treatment were compared between the 2 groups.Results After 3 months of treatment,the clinical efficacy in the observation group was higher than that in the control(93.33%vs 77.78%,P<0.05).The adverse reaction rate revealed no statistical difference between the two groups(P>0.05),and the acute attack frequency in the observation group was(0.98±0.12)times,which was lower than that of(1.11±0.19)times in the control(P<0.05).The forced expiratory volume in one second(FEV1),forced vital capacity(FVC),peak expiratory flow(PEF)and arterial partial pressure of oxygen(PaO_(2))in the two groups were enhanced after 3 months of treatment than those before treatment.The above indexes in the observation group were higher than those in the control((2.88±0.41)L vs(2.62±0.43)L,(3.21±0.33)L vs(2.94±0.40)L,(60.13±5.23)L·min^(-1) vs(57.27±5.27)L·min^(-1),(77.17±2.34)mm Hg(1 mm Hg≈0.133 kPa)vs(75.51±2.20)mm Hg,P<0.05).Serum TIMP-1,LTB4 and arterial partial pressure of carbon dioxide(PaCO_(2))were reduced in both groups than those before treatment,and the observation group had lower indicators((58.32±4.10)μg·L^(-1) vs(60.97±4.36)μg·L^(-1),(106.56±6.79)ng·L^(-1) vs(110.23±7.57)ng·L^(-1),(46.58±2.42)mm Hg vs(48.43±2.46)mm Hg,P<0.05).Conclusion Glycopyrronium bromide formoterol fumarate inhalation aerosol has good efficacy and safety in the treatment of patients with stable COPD,and can significantly improve the levels of pulmonary function indexes,serum TIMP-1,LTB4 and arterial blood gas indexes.