噻托溴铵与孟鲁司特联合治疗对慢性阻塞性肺疾病患者肺功能、痰液炎性细胞及炎性因子表达的影响
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摘要
目的探讨噻托溴铵与孟鲁司特联合治疗对慢性阻塞性肺疾病(COPD)患者的肺功能、痰液炎性细胞及炎性因子表达的影响。方法选取2017年4月~2018年3月我院收治的86例COPD患者,采用随机数字表法将其分为对照组、观察组,每组43例。对照组予以茶碱缓释片口服治疗,研究组予以噻托溴铵联合孟鲁司特治疗。比较两组患者干预前后第一秒用力呼气量(FEV)、肺活量(FVC)、第一秒用力呼气量占肺活量比例(FEV1/FVC)水平、痰液髓过氧化物酶(MPO)、白细胞介素(IL)-8、白三烯B4(LTB4)水平、中性粒细胞以及嗜酸粒细胞水平。结果干预前,两组患者肺功能相关指标的比较,差异均无统计学意义(P>0.05);干预后,两组患者的肺功能相关指标均高于干预前,差异均有统计学意义(P<0.05)。研究组患者的肺功能相关指标均高于对照组,差异均有统计学意义(P<0.05)。干预前,两组患者的痰液炎性因子比较,差异均无统计学意义(P>0.05);干预后,两组患者的痰液炎性因子均低于干预前,差异均有统计学意义(P<0.05),研究组患者的痰液炎性因子均低于对照组,差异均有统计学意义(P<0.05)。干预前,两组患者的诱导痰液炎性细胞比较,差异均无统计学意义(P>0.05);干预后,两组患者的诱导痰液炎性细胞均低于干预前,差异均有统计学意义(P<0.05);研究组患者的诱导痰液炎性细胞均低于对照组,差异均有统计学意义(P<0.05)。结论噻托溴铵联合孟鲁司特治疗COPD可显著改善患者肺功能,降低痰液炎性因子水平,减少痰液炎性细胞。
Objective To investigate the effect of Tiotropium Bromide combined with Montelukast on lung function, inflammatory cells in sputum and expression of inflammatory factors in patients with chronic obstructive pulmonary disease(COPD). Methods A total of 86 COPD patients admitted to our hospital from April 2017 to March 2018 were selected and divided into control group and observation group with 43 cases in each group by random number table method. The control group was treated with Theophylline Sustained-release Tablets orally, while the study group was treated with Tiotropium Bromide combined with Montelukast. The levels of forced expiratory volume(FEV1), vital capacity(FVC), ratio of forced expiratory volume to vital capacity(FEV1/FVC), sputum myeloperoxidase(MPO), interleukin(IL)-8, leukotriene B4(LTB4), neutrophils and eosinophils were compared before and after the intervention.Results Before the intervention, there was no statistical difference between the two groups(P>0.05). After the intervention, the lung function related indexes of the two groups were higher than those before the intervention, and the differences were statistically significant(P<0.05). The lung function related indexes of the patients in the study group were higher than those of the control group, and the differences were statistically significant(P<0.05). Before the intervention, there was no statistically significant difference in sputum inflammatory factors between the two groups(P>0.05).After the intervention, the sputum inflammatory factors of the two groups of patients were lower than those before the intervention, the differences were statistically significant(P<0.05), and the sputum inflammatory factors of the patients in the study group were lower than those of the control group, the differences were statistically significant(P<0.05). Before the intervention, there was no statistically significant difference between the two groups in inducing sputum inflammatory cells(P>0.05). After the intervention, the induced sputum inflammatory cells in the two groups were lower than those before the intervention, and the difference was statistically significant(P<0.05). The induced sputum inflammatory cells in the study group were lower than those in the control group, the differences were statistically significant(P <0.05).Conclusion Tiotropium Bromide combined with Montelukast can significantly improve the pulmonary function of COPD patients, reduce the level of inflammatory factors in sputum and reduce inflammatory cells in sputum.
Objective To investigate the effect of Tiotropium Bromide combined with Montelukast on lung function, inflammatory cells in sputum and expression of inflammatory factors in patients with chronic obstructive pulmonary disease(COPD). Methods A total of 86 COPD patients admitted to our hospital from April 2017 to March 2018 were selected and divided into control group and observation group with 43 cases in each group by random number table method. The control group was treated with Theophylline Sustained-release Tablets orally, while the study group was treated with Tiotropium Bromide combined with Montelukast. The levels of forced expiratory volume(FEV1), vital capacity(FVC), ratio of forced expiratory volume to vital capacity(FEV1/FVC), sputum myeloperoxidase(MPO), interleukin(IL)-8, leukotriene B4(LTB4), neutrophils and eosinophils were compared before and after the intervention.Results Before the intervention, there was no statistical difference between the two groups(P>0.05). After the intervention, the lung function related indexes of the two groups were higher than those before the intervention, and the differences were statistically significant(P<0.05). The lung function related indexes of the patients in the study group were higher than those of the control group, and the differences were statistically significant(P<0.05). Before the intervention, there was no statistically significant difference in sputum inflammatory factors between the two groups(P>0.05).After the intervention, the sputum inflammatory factors of the two groups of patients were lower than those before the intervention, the differences were statistically significant(P<0.05), and the sputum inflammatory factors of the patients in the study group were lower than those of the control group, the differences were statistically significant(P<0.05). Before the intervention, there was no statistically significant difference between the two groups in inducing sputum inflammatory cells(P>0.05). After the intervention, the induced sputum inflammatory cells in the two groups were lower than those before the intervention, and the difference was statistically significant(P<0.05). The induced sputum inflammatory cells in the study group were lower than those in the control group, the differences were statistically significant(P <0.05).Conclusion Tiotropium Bromide combined with Montelukast can significantly improve the pulmonary function of COPD patients, reduce the level of inflammatory factors in sputum and reduce inflammatory cells in sputum.
引文
[1]张威,高赏,任魁,等.噻托溴铵和沙美特罗替卡松在COPD稳定期患者的应用及对深吸气量的影响[J].国际呼吸杂志,2016,36(12):898-901.
[2]单淑香,徐向英,刘艳霞,等.噻托溴铵吸入治疗COPD患者痰液炎症细胞计数及相关炎症因子表达变化[J].山东医药,2016,56(3):74-75.
[3]左晟,马红映,孔志斌,等.孟鲁司特在慢性阻塞性肺疾病稳定期患者中的应用[J].临床肺科杂志,2016,21(10):1817-1820.
[4]谢骞,杨春,张银莉.噻托溴铵治疗COPD稳定期患者的疗效及其对血清MMP-9和IL-8的影响[J].海南医学,2016,27(1):34-36.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,6(4):484-491.
[6]袁平,吴国斌,刘欣欣.噻托溴铵联合孟鲁司特钠治疗慢性阻塞性肺疾病患者的疗效分析[J].抗感染药学,2016,10(3):586-589.
[7]曲桂红,孙志芬,张媚霞.孟鲁司特钠治疗中重度稳定期COPD的疗效及其对患者白三烯E4水平的影响[J].海南医学,2016,27(24):3972-3974.
[8]李怡,陈其章.孟鲁司特联合舒利迭对重度COPD稳定期患者炎症因子及肺功能的影响研究[J].卫生职业教育,2017,35(10):142-144.
[9]秦艳.孟鲁司特钠治疗慢性阻塞性肺疾病122例临床疗效观察[J].国际呼吸杂志,2016,36(9):658-661.
[10]赵洪达,许群,刘澄英.噻托溴铵孟鲁司特钠与布地奈德福莫特罗吸入剂联合治疗对老年慢性阻塞性肺疾病患者临床疗效及血清降钙素原和高敏C反应蛋白的影响[J].山西医药杂志,2017,13(21):2638-2640.
[11]孟庆华,李承红,王小江,等.噻托溴铵联合孟鲁司特钠治疗慢性阻塞性肺疾病急性加重期的临床研究[J].西北国防医学杂志,2017,3(1):29-32.
[12]余国雄.孟鲁司特钠对COPD继发肺间质纤维化患者肺功能以及运动耐力的影响[J].医学理论与实践,2017,30(20):3019-3020.
[13]吴娟.孟鲁司特联合噻托溴铵对慢性阻塞性肺疾病患者肺功能、免疫功能及炎性因子的影响研究[J].实用心脑肺血管病杂志,2016,24(12):213-218.
[14]孟庆华,李承红,王小江,等.噻托溴铵联合孟鲁思特对慢性阻塞性肺疾病患者血液流变学、肺功能及血清细胞因子水平的影响[J].海南医学院学报,2016,22(22):2703-2706.
[15]韩颖明.噻托溴铵联合孟鲁司特治疗COPD及对炎性反应的效果[J].检验医学与临床,2017,14(21):3242-3244.
[2]单淑香,徐向英,刘艳霞,等.噻托溴铵吸入治疗COPD患者痰液炎症细胞计数及相关炎症因子表达变化[J].山东医药,2016,56(3):74-75.
[3]左晟,马红映,孔志斌,等.孟鲁司特在慢性阻塞性肺疾病稳定期患者中的应用[J].临床肺科杂志,2016,21(10):1817-1820.
[4]谢骞,杨春,张银莉.噻托溴铵治疗COPD稳定期患者的疗效及其对血清MMP-9和IL-8的影响[J].海南医学,2016,27(1):34-36.
[5]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,6(4):484-491.
[6]袁平,吴国斌,刘欣欣.噻托溴铵联合孟鲁司特钠治疗慢性阻塞性肺疾病患者的疗效分析[J].抗感染药学,2016,10(3):586-589.
[7]曲桂红,孙志芬,张媚霞.孟鲁司特钠治疗中重度稳定期COPD的疗效及其对患者白三烯E4水平的影响[J].海南医学,2016,27(24):3972-3974.
[8]李怡,陈其章.孟鲁司特联合舒利迭对重度COPD稳定期患者炎症因子及肺功能的影响研究[J].卫生职业教育,2017,35(10):142-144.
[9]秦艳.孟鲁司特钠治疗慢性阻塞性肺疾病122例临床疗效观察[J].国际呼吸杂志,2016,36(9):658-661.
[10]赵洪达,许群,刘澄英.噻托溴铵孟鲁司特钠与布地奈德福莫特罗吸入剂联合治疗对老年慢性阻塞性肺疾病患者临床疗效及血清降钙素原和高敏C反应蛋白的影响[J].山西医药杂志,2017,13(21):2638-2640.
[11]孟庆华,李承红,王小江,等.噻托溴铵联合孟鲁司特钠治疗慢性阻塞性肺疾病急性加重期的临床研究[J].西北国防医学杂志,2017,3(1):29-32.
[12]余国雄.孟鲁司特钠对COPD继发肺间质纤维化患者肺功能以及运动耐力的影响[J].医学理论与实践,2017,30(20):3019-3020.
[13]吴娟.孟鲁司特联合噻托溴铵对慢性阻塞性肺疾病患者肺功能、免疫功能及炎性因子的影响研究[J].实用心脑肺血管病杂志,2016,24(12):213-218.
[14]孟庆华,李承红,王小江,等.噻托溴铵联合孟鲁思特对慢性阻塞性肺疾病患者血液流变学、肺功能及血清细胞因子水平的影响[J].海南医学院学报,2016,22(22):2703-2706.
[15]韩颖明.噻托溴铵联合孟鲁司特治疗COPD及对炎性反应的效果[J].检验医学与临床,2017,14(21):3242-3244.