摘要
目的:探讨布地奈德福莫特罗吸入粉雾剂联合噻托溴铵吸入粉雾剂对慢性阻塞性肺疾病(COPD)稳定期患者动脉血气指标、神经元烯醇化酶(NSE)水平的影响。方法:将2020年5月至2023年3月该院呼吸内科收治的COPD稳定期患者105例按随机数字表法分为噻托溴铵组(n=52)与联合组(n=53)。噻托溴铵组患者给予噻托溴铵吸入粉雾剂治疗,1次18μg,1日1次,持续14 d;联合组患者在噻托溴铵组的基础上加用布地奈德福莫特罗吸入粉雾剂治疗,早1次80μg,晚1次4.5μg,1日2次,持续14 d。对比两组患者治疗前后肺功能指标[平均肺动脉压(MPAP)、肺动脉收缩压(PASP)和肺动脉舒张压(PADP)]、气道阻力[呼吸总阻抗(Z5)、气道总黏性阻力(R5)、近端气道黏性阻力(R20)和周边弹性阻力(X5)]、动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]、诱导痰炎症指标[细胞间黏附因子(ICAM-1)、超敏C反应蛋白(hs-CRP)]及外周血相关指标[前白蛋白(PA)、纤维连接蛋白(FN)及神经元特异性烯醇化酶(NSE)]水平变化,统计不良反应发生情况。结果:治疗后,两组患者的MPAP、PASP及PADP水平显著降低,Z5、R5、R20及X5显著降低,诱导痰ICAM-1、hs-CRP水平显著降低,且联合组患者显著低于噻托溴铵组,差异均有统计学意义(P<0.05)。治疗后,两组患者的PaO_(2)显著升高,PaCO_(2)显著降低;且联合组患者的PaO_(2)显著高于噻托溴铵组,PaCO_(2)显著低于噻托溴铵组,差异均有统计学意义(P<0.05)。治疗后,两组患者的PA、FN水平显著升高,NSE水平显著降低;且联合组患者的PA、FN水平显著高于噻托溴铵组,NSE水平显著低于噻托溴铵组,差异均有统计学意义(P<0.05)。联合组、噻托溴铵组患者不良反应发生率比较[7.55%(4/53)vs.3.85%(2/52)],差异无统计学意义(P>0.05)。结论:布地奈德福莫特罗吸入粉雾剂联合噻托溴铵吸入粉雾剂可有效恢复COPD稳定期患者的肺功能,改善血气指标,抑制炎症反应,促进机体恢复,且安全性高。
OBJECTIVE:To probe into the effects of budesonide and formoterol fumarate powder for inhalation combined with tiotropium bromide powder for inhalation on arterial blood gas indicators and neuron-specific enolase(NSE)level in patients with chronic obstructive pulmonary disease(COPD)in stable phase.METHODS:A total of 105 patients with COPD in stable phase admitted into the department of respiratory medicine in this hospital from May 2020 to Mar.2023 were selected to be divided into the tiotropium bromide group(52 cases)and combined group(53 cases)via random number table method.The tiotropium bromide group was given tiotropium bromide powder for inhalation of 18μg each time,once a day for 14 d;while the combined group received budesonide and formoterol fumarate powder for inhalation based on the tiotropium bromide group,with 80μg each time in the morning and 4.5μg each time in the evening,twice a day for 14 d.Changes of the pulmonary function indicators[mean pulmonary artery pressure(MPAP),pulmonary arterial systolic pressure(PASP)and pulmonary artery diastolic pressure(PADP)],airway resistance[total airway impedance(Z5),total airway viscous resistance(R5),proximal airway viscous resistance(R20)and peripheral elastic resistance(X5)],arterial blood gas indicators[partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))],induced sputum inflammatory indicators[intercellular adhesion molecule-1(ICAM-1)and hypersensitive C-reactive protein(hs-CRP)]and peripheral blood related indicators[prealbumin(PA),fibronectin(FN),neuron-specific enolase(NSE)]were compared between two groups before and after treatment,and the incidences of adverse drug reactions were statistically analyzed.RESULTS:After treatment,the MPAP,PASP and PADP levels decreased significantly,the Z5,R5,R20 and X5 levels decreased significantly,the neuron-specific enolase ICAM-1 and hs-CRP decreased significantly in both groups,and those of the combined group were significantly lower than the tiotropium bromide group,with statistically significant differences(P<0.05).After treatment,PaO_(2) increased significantly and PaCO_(2) decreased significantly in both groups;the PaO_(2) was higher and the PaCO_(2) was lower in the combined group than those in the tiotropium bromide group,with statistically significant differences(P<0.05).After treatment,the PA and FN level increased significantly,the NSE level decreased significantly in both groups;the PA and FN levels were significantly higher and the NSE level was significantly lower in the combined group than those in the tiotropium bromide group,with statistically significant differences(P<0.05).The difference in the incidences of adverse drug reactions between combined group and tiotropium bromide group[7.55%(4/53)vs.3.85%(2/52)]was not statistically significant(P>0.05).CONCLUSIONS:The combination of budesonide and formoterol fumarate powder for inhalation and tiotropium bromide powder for inhalation can effectively restore the pulmonary function in patients with COPD in stable phase,which can improve blood gas indicators,inhibit inflammatory reactions and promote physical recovery,with high safety.
作者
胡媛春
蔡晓玉
HU Yuanchun;CAI Xiaoyu(Dept.of Respiratory Medicine,the Third People’s Hospital of Chengdu,Chengdu 610000,China;Dept.of Respiratory and Critical Care Medicine,the Third People’s Hospital of Chengdu,Chengdu 610000,China)
出处
《中国医院用药评价与分析》
2024年第12期1480-1483,1489,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
慢性阻塞性肺疾病
布地奈德福莫特罗吸入粉雾剂
噻托溴铵吸入粉雾剂
肺功能
Chronic obstructive pulmonary disease
Budesonide and formoterol fumarate powder for inhalation
Tiotropium bromide powder for inhalation
Pulmonary function
