选择性胆碱能受体拮抗剂辅助治疗老年重度慢性阻塞性肺疾病疗效的探讨.docVIP

选择性胆碱能受体拮抗剂辅助治疗老年重度慢性阻塞性肺疾病疗效的探讨 　　【摘要】 目的 探讨选择性胆碱能受体拮抗剂辅助治疗老年重度慢性阻塞性肺疾病（COPD）临床疗效。方法 100例老年重度慢性阻塞性肺疾病患者， 以随机数字表法分为对照组和联合组， 每组50例。对照组单用沙美特罗替卡松治疗， 联合组则在对照组基础上加用噻托溴铵辅助治疗。比较两组患者近期疗效、不良反应发生情况及治疗前后的呼吸困难症状评分、用力肺活量（FVC）、第1秒钟用力呼吸容积（FEV1）及FEV1占预计值百分比（FEV1%）水平。结果 联合组患者的近期治疗总有效率96.00%显著高于对照组的78.00%， 差异具有统计学意义（P0.05）。结论 选择性胆碱能受体拮抗剂辅助治疗老年重度慢性阻塞性肺疾病可有效减轻相关症状体征， 提高肺部通气功能， 且未加重药物不良反应。 　　【关键词】 选择性胆碱能受体拮抗??；慢性阻塞性肺疾病；老年；疗效；安全性 　　DOI：10.14163/j.cnki.11-5547/r.2018.09.001 　　【Abstract】 Objective To discuss the clinical efficacy of selective cholinergic receptor antagonist in the treatment of severe chronic obstructive pulmonary disease （COPD） in the elderly. Methods A total of 100 elderly patients with severe chronic obstructive pulmonary disease were divided by random number table method into control group and combined group， with 50 cases in each group. The control group was treated with salmeterol/fluticasone， and the combined group was treated with tiotropium bromide on the basis of the control group. Comparison were made on short - term efficacy， occurrence of adverse reactions， and respiratory dyspnea symptom score， forced vital capacity （FVC）， forced breathing volume in 1 second （FEV1） and FEV1 percentage of expected value （FEV1%） before and after treatment between the two groups. Results The combined group had obviously higher total effective rate of short - term treatment as 96.00% than 78.00% in the control group， and the difference was statistically significant （P0.05）. Conclusion Selective cholinergic receptor antagonist can effectively reduce related symptoms and signs of chronic obstructive pulmonary disease in the elderly and improve pulmonary ventilation function without aggravating of adverse drug reactions. 　　【Key words】 Selective cholinergic receptor antagonist； Chronic obstructive pulmonary disease； Elderly； Efficacy； Safety 　　慢性阻塞性肺疾病治疗目前多采用糖皮质激素+β受体激动剂方案， 但在重度慢性阻塞性肺疾病特别是老年人群治疗方面总体效果欠佳 [1]；近年来选择性胆碱能受体拮抗剂被逐渐用于慢性阻塞性肺疾病临床辅助治疗， 并取得令人满意效果[2]。本文旨在探讨选择性胆碱能受体拮抗剂辅助治疗老年