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目的探讨噻托溴铵结合无创通气对慢性阻塞性肺疾病稳定期患者肺功能的影响,为慢性阻塞性肺疾病的治疗提供依据。方法 72例慢性阻塞性肺部疾病稳定期患者随机分为噻托溴胺治疗组(治疗组)与舒利迭治疗组(对照组),每组36例,两组均给予早期无创通气治疗,治疗组给予噻托溴铵辅助治疗,对照组给予舒利迭辅助治疗,连续治疗3个月,观察两组1 s用力呼气容积(FEV1)、1 s用力呼气容积/用力肺活量(FEV1/FVC)、血清白细胞介素(IL)6和IL-10水平以及不良反应发生情况。结果治疗后两组的FEV1和FEV1/FVC值均明显高于治疗前,治疗组治疗后FEV1和FEV1/FVC值较对照组治疗后明显升高,差异均有统计学意义(P<0.05)。两组治疗前血清IL-6和IL-10水平差异无统计学意义(P>0.05),治疗后较治疗前明显降低,差异有统计学意义(P<0.05),治疗后治疗组血清IL-6和IL-10水平明显低于对照组治疗后,差异有统计学意义(P<0.05)。治疗后治疗组症状、活动能力、日常生活评分[分别为(78.93±7.10)、(85.39±7.22)、(84.92±6.89)分]明显低于对照组[分别为(89.34±7.18)、(91.63±7.44)、(94.38±8.22)分],差异均有统计学意义(P<0.05)。治疗组患者口干、尿潴留、咽部不适、心动过速等不良发生率与对照组比较,差异均无统计学意义(P>0.05)。结论噻托溴铵结合无创通气治疗慢性阻塞性肺疾病稳定期患者能促进肺功能改善,提高患者的生活质量,不良反应少,其作用的发挥与降低炎症表达有关。
Objective To investigate the effect of tiotropium combined with noninvasive ventilation on pulmonary function in patients with chronic obstructive pulmonary disease (COPD) at stable stage and provide evidence for the treatment of chronic obstructive pulmonary disease. Methods Seventy-two patients with stable chronic obstructive pulmonary disease were randomly divided into tiotropium treatment group (treated group) and seretide treatment group (control group), 36 patients in each group. Both groups were given early non-invasive ventilation treatment, The treatment group received tiotropium adjuvant therapy, the control group was given seretide adjuvant therapy, continuous treatment for 3 months, two groups were observed 1 s forced expiratory volume (FEV1), 1 s forced expiratory volume / forced vital capacity (FEV1 / FVC), serum interleukin (IL) 6 and IL-10 levels and the incidence of adverse reactions. Results After treatment, the FEV1 and FEV1 / FVC values in both groups were significantly higher than those before treatment. The FEV1 and FEV1 / FVC values in the treatment group were significantly higher than those in the control group after treatment, with significant differences (P <0.05). There was no significant difference in serum IL-6 and IL-10 levels between the two groups before treatment (P> 0.05), but the difference was statistically significant (P <0.05) 6 and IL-10 levels were significantly lower than the control group after treatment, the difference was statistically significant (P <0.05). The scores of symptom, activity and daily life of the treatment group after treatment were significantly lower than those of the control group [(78.93 ± 7.10), (85.39 ± 7.22), (84.92 ± 6.89) points respectively] (89.34 ± 7.18, 91.63 ± 7.44), (94.38 ± 8.22), respectively. The differences were statistically significant (P <0.05). There was no significant difference in adverse reactions between the treatment group and the control group, such as dry mouth, urinary retention, throat discomfort and tachycardia (P> 0.05). Conclusion Tiotropium combined with noninvasive ventilation in patients with stable chronic obstructive pulmonary disease can promote pulmonary function and improve the quality of life of patients with fewer adverse reactions, its role in play and reduce the expression of inflammation.