噻托溴铵对慢性阻塞性肺疾病稳定期患者的临床疗效观察

Clinical Effect Observation of Tiotropium Bromide for Patients with Chronic Obstructive Pulmonary Disease at Stable Stage

目的分析噻托溴铵对慢性阻塞性肺疾病(COPD)稳定期的临床效果。方法选取2017年4月—2023年3月本院收治的COPD稳定期患者100例为研究对象,并按照随机数字表法分成对照组及观察组,每组50例。其中,对照组采取常规治疗方案,观察组采用常规治疗方案联用噻托溴铵,比较两组肺功能、血清标志物、慢性阻塞性肺疾病评估测试问卷(CAT)评分、呼吸困难严重程度分级评分(MRC)、6min步行距离(6MWD)的差异。结果治疗前,观察组肺功能指标、血清标志物、CAT评分、MRC评分及6MWD评分对比,差异均无统计学意义(P>0.05)。治疗后,观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC均高于对照组(P<0.05);观察组血清基质金属蛋白酶9(MMP-9)、表面活性蛋白D(SP-D)、白介素-17(IL-17)均低于对照组(P<0.05);观察组CAT、MRC评分低于对照组,6MWD水平高于对照组(P<0.05)。结论在COPD的稳定期治疗中,引入噻托溴铵作为治疗手段,能够显著提高患者的临床治疗效果,优化其肺功能,并有效抑制炎症反应,进而减轻患者呼吸困难的症状。这种治疗方法的作用机制与MMP-9、SP-D水平的调控具有一定的关联性。

Objective To analyze clinical effect of tiotropium bromide for chronic obstructive pulmonary disease(COPD)at stable stage.Methods The paper chose 100 stable COPD patients in our hospital from April 2017 to March 2023,and divided them into control group and observation group randomly,with 50 cases in each group.Control group was treated with routine treatment,while observation group with routine treatment combined with tiotropium bromide.Difference in lung function,serum markers,chronic obstructive pulmonary disease assessment questionnaire(CAT)scores,respiratory distress severity grading scores(MRC),and 6-minute walking distance(6MWD)was compared between two groups.Results Before treatment,there was no statistically significant difference in lung function indicators,serum markers,CAT scores,MRC scores,and 6MWD scores between the groups(P>0.05).After treatment,forced vital capacity(FVC),forced expiratory volume at 1 second(FEV1),and FEV1/FVC in observation group was higher than control group(P<0.05).After treatment,serum levels of matrix metalloproteinase-9(MMP-9),surfactant protein D(SPD),and interleukin-17(IL-17)in observation group were lower than control group(P<0.05).After treatment,CAT and MRC scores in observation group were lower than control group,and level of 6MWD was higher than control group(P<0.05).Conclusion The introduction of tiotropium bromide as a therapeutic tool in the stable phase of COPD treatment can significantly improve the clinical therapeutic effect of patients,optimise their lung function and effectively inhibit the inflammatory response,thus reducing the symptoms of dyspnoea.The mechanism of action of this treatment is related to the regulation of MMP-9 and SP-D levels.