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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

21

期数:

2020年02期

页码:

165-169

栏目:

论　著

出版日期:

2020-02-28

文章信息/Info

Title:

Effects of tiotropium bromide on pulmonary function, inflammatory index, immune function and life quality in patients with acute exacerbation of chronic obstructive pulmonary disease

作者:

何淑娟; 杨连生

南京市红十字医院，南京 210001

Author(s):

HEShu-juan; YANGLian-sheng

NanjingRed CrossHospital,Nanjing210000，China Correspondingauthor:HEShu-juan,E-mail:649646266@qq.com

关键词:

噻托溴铵; 急性加重期慢性阻塞性肺病; 肺功能; 炎症指标; 免疫功能; 生活质量

Keywords:

Titropium bromide;  Acute exacerbation of chronic obstructive pulmonary disease;  Pulmonary function;  Inflammatory indicators;  Immune function;  Quality of life

分类号:

R569

DOI:

-

摘要:

目的 探讨噻托溴铵对急性加重期慢性阻塞性肺病（AECOPD）患者肺功能、炎症指标、免疫功能、生 活质量的影响。方法 选取2014年1月至2018年12月南京市红十字医院诊断治疗的160例AECOPD患者作为 研究对象。随机分为观察组与对照组，每组80例。对照组给予异丙托溴铵气雾剂治疗，观察组给予噻托溴铵粉吸 入剂治疗，两组均连续治疗2周。比较两组治疗前后第1 秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1 与用力肺活量比值（FEV1/FVC），T淋巴细胞水平（CD3 +、CD4 +、CD8 +、CD4 + /CD8 +）水平，免疫球蛋白 （IgG、IgA、IgM）水平，血清C反应蛋白（CRP）、肿瘤坏死因子（TNF-α）、白介素-6（IL-6）、白介素-8 （IL-8）水平及生活质量水平。结果 治疗后，两组肺功能指标FVC、FEV1、FEV1/FVC显著高于治疗前 （P<0.05），且观察组治疗后肺功能指标均高于对照组，差异有统计学意义（P<0.05）。两组治疗后CD3 +、 CD4 +、及CD4 + /CD8 +水平均高于治疗前，CD8 +低于治疗前（P<0.05）；治疗后观察组CD3 +、CD4 +以及CD4 + / CD8 +水平显著高于对照组，差异有统计学意义（P<0.05）。治疗后观察组免疫抗体水平IgG、IgA显著高于治疗 前以及对照组治疗后，差异有统计学意义（P<0.05）。两组治疗后炎症指标IL-8、IL-6、TNF-α、CRP显著 低于治疗前，且观察组低于对照组，差异有统计学意义（P<0.05）。治疗后观察组生活质量较本组治疗前及对照 组治疗后改善显著，差异有统计学意义（P<0.05）。观察组不良反应发生率显著低于对照组，差异有统计学意义 （P<0.05）。结论 噻托溴铵治疗AECOPD可有效改善肺功能、提高免疫功能，缓解炎症反应，提高生活质量。

Abstract:

Objective To investigate the effects of tiotropium bromide on pulmonary function, inflam-matory index, immune function and life quality in patients with acute exacerbation of chronic obstruc-tive pulmonary disease. Methods Totally160 cases of patients with acute exacerbation of chronic ob-structive pulmonary disease diagnosed and treated in Nanjing Red Cross Hospital from January 2014 to December2018 were selected, and were randomly divided into the study group and the control group, with80 cases in each group. The control group was treated with ipratropium bromide aerosol and the study group was treated with tiotropium bromide powder inhalation. Both groups were treated continu-ously for two weeks. The levels of forced expiratory volume（FEV1）, forced vital capacity（FVC）, FEV1/FVC, T lymphocyte（CD3 + , CD4 + , CD8 + , CD4 + /CD8 +）, immunoglobulin（IgG, IgA, IgM） in peripheral blood, serum C-reactive protein（CRP）, tumor necrosis factor-α（TNF-α）, interleukin （IL）-6, IL-8, and quality of life were compared between the two groups before and after treatment.Results After treatment, the lung function indexes such as FVC, FEV1, FEV1/FVC were signifi-cantly higher than those before treatment（P<0.05）, and which in the study group were significantly higher than those in the control group after treatment（P<0.05）. When compared with before treat-ment, the levels of CD3 + , CD4 + T lymphocyte and CD4 + /CD8 + were higher, but the level of CD8 + T lymphocyte was lower in both groups, and there were significantly different （P<0.05）. After treat-ment, the CD3 + , CD4 + T lymphocyte levels and CD4 + /CD8 + were significantly higher in the study group than in the control group（P<0.05）. After treatment, the levels of IgG and IgA in the study group were significantly higher than those before treatment, and those in the control group（P<0.05）. The inflammatory indexes namely IL-8, IL-6, TNF-α and CRP levels in the two groups were sig-nificantly lower than those before treatment（P<0.05）. The life quality of the study group was signifi-cantly improved after treatment（P<0.05）, and which was significantly better than the control group （P<0.05）. The incidence of adverse reactions in the study group was significantly lower than that in the control group（P<0.05）. Conclusion Titropium bromide can effectively improve pulmonary func-tion, immune function, alleviate inflammation and improve the quality of life in the treatment of pa-tients with acute exacerbation of chronic obstructive pulmonary disease.

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备注/Memo

备注/Memo:

作者简介：何淑娟，硕士，副主任医师，研究方向：慢性阻塞性肺病 通信作者：杨连生，E-mail：649646266@qq.com

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更新日期/Last Update: 2020-02-28