摘要
目的比较慢性阻塞性肺疾病(COPD)急性期及稳定期患者吸入布地奈德福莫特罗治疗前后气道阻力的影响。方法按GOLD指南综合评估选取80例门诊及住院COPD中C-D组患者,随机分为两组,对照组(n=40)使用噻托溴铵18μg1粒/d,观察组(n=40)在此基础上加用布地奈德福莫特罗(160/4.5μg),每次2吸,早晚各1次吸入治疗。出院后定期门诊随访,随访期限12个月。肺功能体积描记法和脉冲振荡法比较急性期和稳定期肺功能气道阻力生理参数指标变化。结果布地奈德福莫特罗治疗12个月后,稳定期可改善小气道阻力的MMEF%预计值、V50%预计值流速,减少气道粘性阻力,降低气道阻力。急性期中心气道阻力和总气道阻力较稳定期增加,可延缓气道阻力增加的速度和程度,差异有统计学意义(P<0.05)。气道粘性阻力与体积描记法气道阻力具有显著相关性,气道阻力增加,响应频率相应增加,周边弹性阻力与V25具有显著相关性(P<0.05)。结论长期规律使用布地奈德福莫特罗联合噻托溴铵治疗COPD,急性期与稳定期均可减少气道粘性阻力,延缓小气道气流流速下降速度,改善小气道流速通气状况,降低总气道阻力,减少急性加重发生频率。
Objective To investigate the effects of inhalation of budesonide formoterol on airway resistance in patients with chronic obstructive pulmonary disease(COPD)in acute or stable stage.Methods According to the comprehensive evaluation of GOLD guidelines,80 patients with COPD were selected and randomly divided into two groups.The control group was treated with tiotropium bromide,and the experimental group was treated with budesonide formoterol on this basis.After discharge,patients were regularly followed up for 12 months.Pulmonary function was assessed with plethysmography and impulse oscillometry system for comparison.Results After 12 months of treatment with budesonide formoterol,the MMER%and V50%estimated flow rate,small airway resistance,airway viscosity resistance and airway resistance were improved in the stable stage.In the acute stage,central airway resistance and total airway resistance were significantly increased compared with the stable stage,which could delay the increase speed and degree of airway resistance(P<0.05).There was a significant correlation between the airway viscous resistance and the airway resistance plethysmography.As the airway resistance increased,the response frequency was correspondingly increased,and the peripheral elastic resistance was significantly correlated with V25(P<0.05).Conclusion long-term regular use of budesonide formoterol combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease can reduce airway viscous resistance,slow down airflow velocity decline rate of small airway,improve airflow velocity ventilation condition,reduce total airway resistance and the frequency of acute exacerbation.
作者
李艳萍
殷俊
杨旖
贺孟君
LI Yan-ping;YIN Jun;YANG Yi;HE Meng-jun(Department of Respiratory and Critical Care Medicine,the Third People′s Hospital of Chengdu/the Second Affiliated Hospital of Chengdu,Chongqing Medical University,Chengdu 610031,Sichuan,China)
出处
《广东医学》
CAS
2020年第22期2307-2311,共5页
Guangdong Medical Journal
基金
成都市卫计委科研课题(2015174)。
关键词
慢性阻塞性肺疾病
布地奈德福莫特罗
噻托溴铵
气道阻力
肺功能
chronic obstructive pulmonary disease
budesonide formoterol
tiotropium bromide
airway resistance
lung function
