沙美特罗联合丙酸氟替卡松治疗老年COPD效果及对血清MMP-2和MMP-9水平的影响研究

摘要

目的 研究对沙美特罗联合丙酸氟替卡松治疗老年慢性阻塞性肺病(COPD)的效果及对血清基质金属蛋白酶-2(MMP-2)、MMPO水平的影响进行研究,为临床治疗提供参考.方法 150例COPD患者随机分为沙美特罗治疗组、丙酸氟替卡松治疗组和沙美特罗联合丙酸氟替卡松治疗组,每组50例.分析治疗后患者的肺功能改善情况,并检测治疗前后患者血清中基质金属蛋白酶及其抑制剂、缝隙连接蛋白和白细胞介素水平变化.结果 研究发现经沙美特罗联合丙酸氟替卡松治疗组治疗后老年COPD患者肺功能FEV1、FVC、FEV1/FVC得到明显改善(P＜0.05),血清中基质金属蛋白酶及其抑制剂水平明显降低而缝隙连接蛋白水平明显升高(P＜0.05).结论 沙美特罗联合丙酸氟替卡松能通过抑制基质金属蛋白酶及其抑制剂、提高缝隙连接蛋白表达发挥治疗老年慢性阻塞性肺病的作用.%Objective To investigate the therapeutic effects of salmeterol combined with fluticasone propionate on chronic obstructive pulmonary disease (COPD) in the elderly and its effects on serum levels of metalloproteinase (MMP-2,MMP-9).Methods A total of 150 elderly patients with COPD who were treated in our hospital from April 2011 to April 2015 were randomly divided into salmeterol treatment group,fluticasone propionate treatment group and combination treatment group (salmeterol + fluticasone propionate),with 50 patients in each group.After treatment the improvement state of pulmonary function,the changes of serum levels metalloproteinases and its inhibitors,gap connexins,interleukins were observed and compared among the three groups.Results The pulmonary function parameters including FEV1,FVC and FEV1/FVC were significantly improved in combination treatment group (P ＜ 0.05),moreover,the serum levels of metalloproteinases and its inhibitors were significantly decreased,however,the levels of connexins were significantly increased,as compared with those in the other two groups (P ＜ 0.05).Conclusion The salmeterol combined fluticasone propionate are effective in treating COPD in the elderly,and the action mechanism may be related with their inhibitory effects on the expressions of metalloproteinases and its inhibitors,and with enhancement of expressions of gap connexins.