目的 探讨噻托溴铵联合舒利迭雾化吸入治疗对中重度慢性阻塞性肺疾病(COPD)患者肺功能及预后的影响.方法 将91例中重度COPD患者分为观察组(n=48)和对照组(n=43).对照组患者仅给予舒利迭进行雾化治疗,观察组在上述基础上联合噻托溴铵进行雾化吸入治疗,比较治疗前后2组患者的肺功能水平及预后状况.结果 治疗后,观察组的FEV1、FVC、FEV1/FVC/％以及FEV1％pre水平均显著高于对照组(P<0.05).观察组治疗后的p(O2)、p(CO2)显著优于对照组(P<0.05).观察组患者治疗后的hs-CRP、IL-6以及PCT等炎性因子水平均显著低于对照组(P<0.05).观察组患者治疗后的呼吸困难评分、CAT评分及各项SGRQ评分也均显著低于对照组,6 min步行试验显著大于对照组(P<0.05).结论 噻托溴铵联合舒利迭雾化吸入治疗中重度COPD患者,能够显著改善患者的肺功能状况及动脉血气状况,缓解炎症反应,值得推广.%Objective To explore the effects of tiotropium combined with seretide inhalation therapy on pulmonary function and prognosis of patients with moderate and severe chronic obstructive pulmonary disease(COPD).Methods A total of 91 patients with moderate and severe COPD were divided into observation group(n=48)and control group(n=43).The control group was only given seretide inhalation,while the observation group was given additional tiotropium bromide inhalation therapy on the basis of the control group.The pulmonary function and prognosis before and after treatment were compared between the two groups.Results After treatment,the levels of FEV1,FVC,FEV1/FVC/％and FEV1％pre in the observation group were significantly higher than those in the control group(P<0.05).In the observation group,the p(O2),p(CO2)after treatment were significantly better than the control group(P<0.05).The levels of hs-CRP,IL-6 and PCT were significantly lower in the observation group than the control group(P<0.05).The dyspnea score,CAT score and SGRQ score of the observation group after treatment were significantly lower than those of the control group,and the 6 min walking test was significantly higher than the control group(P<0.05).Conclusion For patients with moderate and severe COPD,tiotropium combined with seretide inhalation therapy can significantly improve their pulmonary functions and arterial blood gas status,alleviate inflammatory response,so it is worthy of popularization.
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