COPD患者联合使用噻托溴铵及沙美特罗-丙酸氟替卡松疗效评估.doc

COPD患者联合使用噻托溴铵及沙美特罗/丙酸氟替卡松疗效评估 　【摘要】 目的 探讨联合使用噻托溴铵和沙美特罗/丙酸氟替卡松对慢性阻塞性肺疾病（COPD）患者肺功能及动脉血气的影响。方法 42例COPD患者随机分为试验组（20例）和对照组（22例）。两组入院后在住院期间均予常规吸氧、抗感染、止咳、化痰、平喘（静点氨茶碱）等对症治疗。试验组联合使用噻托溴铵和沙美特罗/丙酸氟替卡松吸入,对照组仅使用噻托溴铵。出院后试验组继续使用噻托溴铵和沙美特罗/丙酸氟替卡松，对照组继续使用噻托溴铵，共随访观察疗程6周。两组均于治疗前测定肺功能及动脉血气，治疗7天后及6周后再次测定上述参数。结果 治疗前,两组肺功能及动脉血气均无明显差异;治疗后,两组肺功能及动脉血气较治疗前均有改善（Plt;0.01）。试验组用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占预计值百分比（FEV1％Pred）、动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）比对照组改善更加明显，差异有显著性（Plt;0.05）。结论 联合使用噻托溴铵和沙美特罗/丙酸氟替卡松较单独使用噻托溴铵对慢性阻塞性肺疾病（COPD）患者肺功能及动脉血气有更加明显的改善作用。 【关键词】 慢性阻塞性肺疾病 肺功能试验 血气分析 噻托溴铵 沙美特罗 丙酸氟替卡松 【Abstract】 Objective To explore the effects of combining tiotropium bromide and salmeterol/fluticasone propionate on patients with COPD by analysing lung function and arterial blood gas relevant parameters.Methods 42 patients with COPD were randomly divided into two groups:experimental group（20 cases） and control group（22 cases）.The basic regimens for the two groups were oxygen inhalation, antibiotics ,aminophylline , stopping coughing and eliminating sputum. The experimental group was given tiotropium bromide and salmeterol/fluticasone propionate.The control group was given tiotropium bromide. After leaving hospital , the experimental group continued using tiotropium bromide and salmeterol/fluticasone propionate;the control group continued using tiotropium bromide during 6 weeks.All patients underwent pulmonary function test and arterial blood gas analysis before treatment,7 days and 6 weeks after therapy.Results Before treatment ,lung function and arterial blood gas relevant parameters in both groups are not statistically different （Pgt;0.05）.After therapy, there was improvement of lung function and arterial blood gas relevant parameters in both groups than befroe treatment（Plt;0.01）. FVC，FEV1 ,FEV1%Pred, PaO2 and PaCO2 were superior in experimental group to control group.Conclusion Compared with using tiotropium bromide alone, combining tiotropium and salmeterol/fluticasone propionate can improve lu