作者：赵守焱，尚建欣，褚春红

单位：

150086黑龙江省哈尔滨市，中国人民解放军联勤保障部队第962医院呼吸内科 通信作者：赵守焱，E-mail：yxzzd001@163.com

Units：

Department of Respiratory Medicine, the 962th Hospital of the Joint Logistics Support Force of the Chinese People's LiberationArmy, Harbin 150086, China Corresponding author: ZHAO Shouyan, E-mail: yxzzd001@163.com

关键词：

慢性阻塞性肺疾病; 噻托溴铵; 马来酸茚达特罗; 炎症因子; T淋巴细胞亚群; 肺功能;

Keywords：

Chronic obstructive pulmonary disease; Tiotropium bromide; Indacaterol maleate; Inflammatory factors;T-lymphocyte subsets; Pulmonary function

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.139

Funds：

摘要：

目的 探讨噻托溴铵联合马来酸茚达特罗在稳定期慢性阻塞性肺疾病(COPD)患者中的应用效果及安全性。方法 前瞻性选取2018年7月至2019年12月中国人民解放军联勤保障部队第962医院收治的稳定期COPD患者120例为研究对象,按照随机数字表法将其分为A、B、C组,每组40例。其中A组中途退出3例,B组中途退出2例,C组中途退出1例。在常规治疗基础上,A组给予噻托溴铵粉吸入剂吸入治疗,B组给予马来酸茚达特罗粉吸入剂吸入治疗,C组给予噻托溴铵联合马来酸茚达特罗吸入粉雾剂吸入治疗;三组患者均连续治疗24周。比较两组患者治疗前及治疗24周末血清炎症因子水平、T淋巴细胞亚群、肺功能指标,并观察三组患者治疗期间不良反应发生情况。结果治疗24周末,C组患者血清白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)水平低于A、B组(P<0.05)。治疗24周末,C组患者CD3+T淋巴细胞分数、CD4+T淋巴细胞分数、CD4+/CD8+T淋巴细胞比值高于A、B组,CD8+T淋巴细胞分数低于A、B组(P<0.05)。治疗24周末,C组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV1)大于A、B组,呼气峰流速占预计值的百分比(PEFpred%)、FEV1/FVC高于A、B组(P<0.05)。三组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论 噻托溴铵联合马来酸茚达特罗能有效抑制稳定期COPD患者炎症反应,调节细胞免疫功能,进而促进患者肺功能恢复,且未增加药物相关不良反应。

Abstract：

【Abstract】 Objective To investigate the application effect and safety of tiotropium bromide combined withindacaterol maleate in patients with stable chronic obstructive pulmonary disease (COPD) . Methods A total of 120 patients withstable COPD treated in the 962th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from July2018 to December 2019 were prospectively selected as the research objects. They were divided into groups A, B and C accordingto the random number table method, with 40 cases in each group. Three patients in group A withdrew halfway, two patients ingroup B withdrew halfway, one patient in group C withdrew halfway. On the basis of routine treatment, the patients in the groupA was treated with tiotropium bromide powder for inhalation, group B was treated with indacaterol maleate powder for inhalation,and group C was treated with tiotropium bromide powder for inhalation combined with indacaterol maleate powder for inhalation;the three groups were all treated for 24 weeks. The levels of serum inflammatory factors, T-lymphocyte subsets and pulmonaryfunction indexes were compared between the two groups before treatment and at the end of 24 weeks of treatment, and the adversereactions of the three groups during treatment were observed. Results At the end of 24 weeks of treatment, the serum levels ofinterleukin-6 (IL-6) , tumor necrosis factor α (TNF-α) and C-reactive protein (CRP) in the group C were lower than those inthe groups A and B (P < 0.05) . At the end of 24 weeks of treatment, the percentage of CD3+ T lymphocytes, CD4+T lymphocytesand CD4+ /CD8+ T lymphocytes ratio in the group C were higher than those in the groups A and B, and the CD8+T lymphocytespercentage was lower than that in the groups A and B (P < 0.05) . At the end of 24 weeks of treatment, the forced vital capacity(FVC) and forced expiratory volume in the first second (FEV1) in the group C were greater than those in the groups A and B, andthe percentage of peak expiratory velocity to the expected value (PEFpred%) and FEV1/FVC were higher than those in the groupsA and B (P < 0.05) . There was no significant difference in the incidence of adverse reactions among the three groups (P > 0.05) .ConclusionTiotropium bromide combined with indacaterol maleate can effectively inhibit the inflammatory response of stableCOPD patients, regulate cellular immune function, and then promote the recovery of pulmonary function, without increasing drugrelated adverse reactions.

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