噻托溴铵联合舒利迭对COPD急性期并发呼吸衰竭临床效果、肺功能及炎症因子影响
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摘要
目的:分析急性期COPD并呼吸衰竭联合应用噻托溴铵、舒利迭治疗的临床效果及肺部功能、炎症因子变化。方法:笔者所在医院临床资料采集于2017年12月-2018年12月呼吸内科诊治的70例急性期COPD并呼吸衰竭患者,按不同治疗方案分为两组,每组35例,对照组治疗药物为舒利迭,观察组在其基础上联合药物噻托溴铵治疗,比较两组临床疗效、肺部功能及炎症反应。结果:观察组治疗8周的总有效率94.29%,相较于对照组高(P<0.05);观察组治疗8周后的FEV1(1.56±0.33)L、FVC(2.56±0.45)L、PEFR(3.56±0.88)L/s,相较于对照组均更高(P<0.01);观察组治疗8周的CRP(25.98±3.11)mg/L、PCT(0.08±0.02)μg/L、IL-6(11.21±1.95)ng/L,相较于对照组水平均有所下降(P<0.01)。结论:急性期COPD并呼吸衰竭经噻托溴铵、舒利迭联合治疗后,临床疗效提高,且肺部功能改善,气道炎症缓解,效果显著。
Objective:To analyze the clinical effects and changes of pulmonary function and inflammatory factors in patients with acute COPD and respiratory failure combined with Tiotropium Bromide and Seretide.Method:The clinical data of our hospital were collected 70 patients with acute COPD and respiratory failure diagnosed in the department of respiratory medicine from December 2017 to December 2018.According to different treatment options,they were divided into two groups,35 cases in each group.The control group was treated with Seretide.The observation group was treated with the basic combination drug Tiotropium Bromide,and the clinical efficacy,lung function and inflammatory response were compared between the two groups.Result:The total effective rate of the observation group was 94.29% after 8 weeks of treatment,which was higher than that of the control group(P<0.05).The FEV1(1.56±0.33)L,FVC(2.56±0.45)L, PEFR(3.56±0.88)L/s in the observation group after 8 weeks of treatment were higher than those in the control group(P<0.01).The CRP(25.98±3.11)mg/L, PCT(0.08±0.02)μg/L,IL-6(11.21±1.95)ng/L in the observation group were lower than those in the control group after 8 weeks of treatment(P<0.01).Conclusion:In the acute phase of COPD and respiratory failure,the combination of Tiotropium Bromide and Seretide improves the clinical efficacy,improves lung function,and relieves airway inflammation,and the effect is significant.
Objective:To analyze the clinical effects and changes of pulmonary function and inflammatory factors in patients with acute COPD and respiratory failure combined with Tiotropium Bromide and Seretide.Method:The clinical data of our hospital were collected 70 patients with acute COPD and respiratory failure diagnosed in the department of respiratory medicine from December 2017 to December 2018.According to different treatment options,they were divided into two groups,35 cases in each group.The control group was treated with Seretide.The observation group was treated with the basic combination drug Tiotropium Bromide,and the clinical efficacy,lung function and inflammatory response were compared between the two groups.Result:The total effective rate of the observation group was 94.29% after 8 weeks of treatment,which was higher than that of the control group(P<0.05).The FEV1(1.56±0.33)L,FVC(2.56±0.45)L, PEFR(3.56±0.88)L/s in the observation group after 8 weeks of treatment were higher than those in the control group(P<0.01).The CRP(25.98±3.11)mg/L, PCT(0.08±0.02)μg/L,IL-6(11.21±1.95)ng/L in the observation group were lower than those in the control group after 8 weeks of treatment(P<0.01).Conclusion:In the acute phase of COPD and respiratory failure,the combination of Tiotropium Bromide and Seretide improves the clinical efficacy,improves lung function,and relieves airway inflammation,and the effect is significant.
引文
[1]克比努尔·阿布力孜,范林霞,王安平.老年慢性阻塞性肺疾病急性加重期的临床急救[J].中华临床医师杂志,2017,11(13):2010-2012.
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[4]卞庆平.噻托溴铵联合舒利迭对中重度COPD患者炎症因子、血气指标及肺功能的影响[J].临床肺科杂志,2019,24(1):58-60.
[5]中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性阻塞性肺疾病基层诊疗指南(2018年)[J].中华全科医师杂志,2018,17(11):856-870.
[6]董健,张振建,金志强.沙美特罗替卡松粉吸入剂联合无创呼吸机治疗COPD并发呼吸衰竭的临床效果分析[J].解放军医药杂志,2018,30(9):84-88.
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[8]林贻照,王芳,张荣照,等.沙丁胺醇联合无创呼吸机对慢性阻塞性肺病合并呼吸衰竭患者TNF-α、IL-6、IL-8及血清CK-MB活性影响研究[J].中国生化药物杂志,2015,35(12):136-138.
[9]肖立东.无创正压通气在COPD急性加重期呼吸衰竭治疗中的作用[J].中外医学研究,2018,16(34):151-152.
[10]韩芳芳,韩晓惠,温少虎,等.噻托溴铵联合舒利迭对COPD急性期并发呼吸衰竭患者肺功能的改善作用[J].临床医学研究与实践,2019,4(1):35-36.
[11]吴超,孙明.舒利迭和信必可都保治疗慢性阻塞性肺疾病的临床对照研究[J].中国现代药物应用,2018,12(18):1-3.
[12]李荣凯.舒利迭联合噻托溴铵治疗慢性阻塞性肺疾病66例效果观察[J].中国疗养医学,2019,28(2):203-204.
[13]方琪,郑和豪,崔益明.噻托溴铵粉联合痰热清注射液治疗慢性阻塞性肺部疾病急性发作及对肿瘤坏死因子-α、降钙素原、C反应蛋白的影响[J].中华中医药学刊,2018,36(11):2738-2742.
[2]张昭,张婷婷,彭瑞敏,等.不同雾化吸入方式对慢性阻塞性肺疾病急性期的临床疗效[J].中华肺部疾病杂志,2015,8(4):470-471.
[3]刘丽娟,张齐武,刘宇鹏,等.舒利迭对老年COPD急性加重期患者的疗效及对凝血功能的影响[J].实用药物与临床,2018,21(5):541-544.
[4]卞庆平.噻托溴铵联合舒利迭对中重度COPD患者炎症因子、血气指标及肺功能的影响[J].临床肺科杂志,2019,24(1):58-60.
[5]中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性阻塞性肺疾病基层诊疗指南(2018年)[J].中华全科医师杂志,2018,17(11):856-870.
[6]董健,张振建,金志强.沙美特罗替卡松粉吸入剂联合无创呼吸机治疗COPD并发呼吸衰竭的临床效果分析[J].解放军医药杂志,2018,30(9):84-88.
[7]Patel S P,Pena M E,Babcock C I.Cost-effectiveness of noninvasive ventilation for chronic obstructive pulmonary disease-related respiratory failure in Indian hospitals without ICU facilities[J].Lung India Official Organ of Indian Chest Society,2015,32(6):549-556.
[8]林贻照,王芳,张荣照,等.沙丁胺醇联合无创呼吸机对慢性阻塞性肺病合并呼吸衰竭患者TNF-α、IL-6、IL-8及血清CK-MB活性影响研究[J].中国生化药物杂志,2015,35(12):136-138.
[9]肖立东.无创正压通气在COPD急性加重期呼吸衰竭治疗中的作用[J].中外医学研究,2018,16(34):151-152.
[10]韩芳芳,韩晓惠,温少虎,等.噻托溴铵联合舒利迭对COPD急性期并发呼吸衰竭患者肺功能的改善作用[J].临床医学研究与实践,2019,4(1):35-36.
[11]吴超,孙明.舒利迭和信必可都保治疗慢性阻塞性肺疾病的临床对照研究[J].中国现代药物应用,2018,12(18):1-3.
[12]李荣凯.舒利迭联合噻托溴铵治疗慢性阻塞性肺疾病66例效果观察[J].中国疗养医学,2019,28(2):203-204.
[13]方琪,郑和豪,崔益明.噻托溴铵粉联合痰热清注射液治疗慢性阻塞性肺部疾病急性发作及对肿瘤坏死因子-α、降钙素原、C反应蛋白的影响[J].中华中医药学刊,2018,36(11):2738-2742.