美特罗替卡松联合噻托溴铵治疗矽肺并哮喘效果观察.docVIP

美特罗替卡松联合噻托溴铵治疗矽肺并哮喘效果观察 　　[摘要] 目的 探讨美特罗替卡松联合噻托溴铵治疗矽肺并哮喘的临床效果。 方法 选择2011年1月～2014年6月我院收治的矽肺合并支气管哮喘患者80例，按照随机数字法，分为两组，各40例，所有患者均进行吸氧、抗菌药物预防和治疗感染、营养支持等处理，其中对照组使用美特罗替卡松，每次1吸即含有50mg沙美特罗以及500mg的丙酸氟替卡松，每日进行两次的雾化吸入，观察组在对照组基础上联合使用噻托溴铵，每次18μg雾化吸入，每天1次。两组均连续治疗1个月，比较治疗后两组肺功能及发生的不良反应情况。 结果 观察组治疗后肺功能中FVC、FEV1均显著优于对照组（P0.05）。 结论 美特罗替卡松联合噻托溴铵雾化吸入治疗矽肺合并哮喘，能显著改善患者肺功能，且并发症少，值得临床推广。 　　[关键词] 美特罗替卡松；噻托溴铵；矽肺；哮喘 　　[中图分类号] R562.25 [文献标识码] B [文章编号] 2095-0616（2015）19-112-03 　　[Abstract] Objective To study the clinical effect of salmeterol fluticasone propionate combined tiotropium bromide in the treatment of silicosis complicated asthma. Methods 80 patients with silicosis complicated bronchial asthma，who were treated in our hospital from January 2011 to June 2014，were divided into two groups according to random number table，with 40 cases in each group.All the patients were treated with oxygen inhalation，antibiotics in infection and treatment of prevention， nutritional support and so on.Thereinto，control group was treated with salmeterol fluticasone propionate，with inhaled once time of 50mg salmeterol and 500mg fluticasone propionate，twice a day，observation group was treated with tiotropium bromide based on control group，with inhaled once time of 18ug，twice a day.To treat the two groups for 1 month continuously，to compare pulmonary function and occurrence of adverse reaction after treatment between the two groups. Results FVC，FEV1 of pulmonary function in observation group were significantly better than which in control group（P0.05）. Conclusion Salmeterol fluticasone propionate combined tiotropium bromide aerosol inhalation treatment of silicosis complicated asthma could significantly improve pulmonary function，has less complication， is worthy of clinical popularization. 　　[Key words] Salmeterol fluticasone propionate；Tiotropium bromide；Silicosis；Asthma 　　矽肺是目前职业病中肺部并发症最为常见的一种，主要是因为长期处于二氧化硅粉尘环境中工作，二氧化硅吸入后在肺内潴留，导致肺组织的弥漫性纤维化而出现的一种全身性疾病[1]。研究提示[2]，针对存在肺部合并症的矽肺患者，应积极控制矽肺进展同时控制肺部合并疾病。以往研究较多的是