<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA),...<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.展开更多
目的评估并比较茚达特罗和噻托溴铵单药治疗对慢性阻塞性疾病(简称"慢阻肺")患者气流限制和呼吸阻抗的影响。方法选取2014年3月至2015年1月于我院诊断为慢阻肺患者78例(平均年龄为72.4岁,平均FEV1预计值为61.6%),随机分为两组...目的评估并比较茚达特罗和噻托溴铵单药治疗对慢性阻塞性疾病(简称"慢阻肺")患者气流限制和呼吸阻抗的影响。方法选取2014年3月至2015年1月于我院诊断为慢阻肺患者78例(平均年龄为72.4岁,平均FEV1预计值为61.6%),随机分为两组,每组各39例,分别接受茚达特罗或噻托溴铵治疗。在药物治疗开始及治疗8周后,对患者进行肺功能测试、慢阻肺评估测试(CAT)和多频强迫振荡技术测试。在全呼吸、吸气和呼气阶段测定5 Hz和20 Hz振动频率时的粘性阻力(R_5和R-20),5 Hz时电抗(X——5)和共振频率(Fres)及低频电抗面积(ALX)。结果茚达特罗与噻托溴铵均可改善慢阻肺患者的气流受限情况,平均FEV1值分别提高170 m L和90 m L。患者接受茚达特罗药物治疗后CAT得分由11.2±4.3降为7.5±2.3,治疗前后具有显著性差异(P<0.001)。与噻托溴铵相比,茚达特罗可明显改善患者的FEV1值,FEV1百分比预计值及CAT得分(P分别为0.042,0.008和0.027)。对于呼吸阻抗,两种药物在全呼吸、吸气和呼气阶段都可改变患者的R_5、X_5、Fres及ALX值。茚达特罗组R_5、R_5-R_20、X_5、Fres及ALX值的变化与FEV1变化显著相关。结论茚达特罗可显著改善慢阻肺患者的气流受限情况和症状。对于呼吸阻抗,茚达特罗和噻托溴铵两种支气管扩张药物改善强迫振荡技术参数的程度相似,均可用于慢阻肺患者的临床治疗。展开更多
文摘<strong>Background:</strong> A dual bronchodilator, long-acting anticholine drugs (glycopyrronium, LAMA) and the long running <em>β</em>-<sub>2</sub> stimulant (indacaterol, LABA), are effective for the treatment of chronic obstructive pulmonary disease (COPD). To evaluate the effectiveness of the perioperative intervention of LAMA/LABA, a randomized prospective trial was performed for the lung cancer patients receiving a lobectomy with normal pulmonary function and COPD. <strong>Methods:</strong> Based on the results of the preoperative pulmonary function test, 25 patients were diagnosed with COPD [% forced expiratory volume in 1 second (%FEV<sub>1</sub>) < 70%]. Thirty-seven patients were enrolled as non-obstructive patients (70% ≤ %FEV<sub>1</sub>), who were randomized into two groups, the LAMA/LABA (n = 19) and the Control group (n = 18). The LAMA/LABA and the COPD groups daily received inhaled LAMA (50 μg) and LABA (110 μg) for 1 week before surgery and for least 4 weeks after surgery. The Control group had no treatment of the dual bronchodilator. The actual values were measured during the perioperative pulmonary function at three points of the preoperative baseline, the postoperative 1 week and the postoperative 4 weeks;these changes and changed ratios were then calculated. The patient-reported outcomes of the quality of life (PRO-QOL) were evaluated by the Cancer Dyspnea Scale (CDS), the COPD assessment test, and the St. George’s Respiratory Questionnaire. <strong>Results:</strong> Regarding the value of FEV<sub>1</sub> at the baseline, that in the LAMA/LABA group was 79.2% ± 6.4% and that in the Control group was 80.9% ± 6.4%, but that in the COPD groups was 57.9% ± 8.7%;there was a significant difference between the COPD and the Control group (p < 0.0001). At the postoperative 1 week point, the FEV<sub>1</sub> value in the Control group was 1.3 ± 0.5 L and that in the LAMA/LABA group was 1.7 ± 0.5 L. On the other hand, that in the COPD group was 1.7 ± 0.5 L, which was significantly higher compared to that in the Control group (p = 0.0251 and p = 0.0369). The intervention of LAMA/LABA for the COPD and non-obstructive patients resulted in the less decreased degree of the pulmonary function in FEV<sub>1</sub> compared to that in the Control group. Based on the PRO-QOL by the CDS, the intervention of LAMA/LABA significantly reduced the total dyspnea in the LAMA/LABA group compared to that in the Control group (p = 0.0348). <strong>Conclusion:</strong> The perioperative intervention of LAMA/LABA should lead to maintaining the postoperative pulmonary function of the FEV<sub>1</sub> during the lobectomy with COPD and non-obstructive patients and the improvement of PRO-QOL.
文摘目的评估并比较茚达特罗和噻托溴铵单药治疗对慢性阻塞性疾病(简称"慢阻肺")患者气流限制和呼吸阻抗的影响。方法选取2014年3月至2015年1月于我院诊断为慢阻肺患者78例(平均年龄为72.4岁,平均FEV1预计值为61.6%),随机分为两组,每组各39例,分别接受茚达特罗或噻托溴铵治疗。在药物治疗开始及治疗8周后,对患者进行肺功能测试、慢阻肺评估测试(CAT)和多频强迫振荡技术测试。在全呼吸、吸气和呼气阶段测定5 Hz和20 Hz振动频率时的粘性阻力(R_5和R-20),5 Hz时电抗(X——5)和共振频率(Fres)及低频电抗面积(ALX)。结果茚达特罗与噻托溴铵均可改善慢阻肺患者的气流受限情况,平均FEV1值分别提高170 m L和90 m L。患者接受茚达特罗药物治疗后CAT得分由11.2±4.3降为7.5±2.3,治疗前后具有显著性差异(P<0.001)。与噻托溴铵相比,茚达特罗可明显改善患者的FEV1值,FEV1百分比预计值及CAT得分(P分别为0.042,0.008和0.027)。对于呼吸阻抗,两种药物在全呼吸、吸气和呼气阶段都可改变患者的R_5、X_5、Fres及ALX值。茚达特罗组R_5、R_5-R_20、X_5、Fres及ALX值的变化与FEV1变化显著相关。结论茚达特罗可显著改善慢阻肺患者的气流受限情况和症状。对于呼吸阻抗,茚达特罗和噻托溴铵两种支气管扩张药物改善强迫振荡技术参数的程度相似,均可用于慢阻肺患者的临床治疗。
