噻托溴铵联合茚达特罗治疗慢性阻塞性肺病患者的疗效及对血管内皮功能的影响

摘要

目的:探究茚达特罗联合噻托溴铵治疗慢性阻塞性肺病(COPD)患者的疗效及对血管内皮功能的影响.方法:选取2014年3月至2016年1月收治的COPD稳定期B、C级患者86例,随机分为对照组和联合组,对照组给予茚达特罗吸入治疗,联合组给予茚达特罗联合噻托溴铵吸入治疗,连续用药1年.比较两组治疗前、治疗6个月、治疗12个月后肺功能、生活质量评分、血管内皮功能的变化以及治疗期间急性加重情况.结果:联合组、对照组治疗6、12个月后第1秒用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC、深吸气量、生活质量评分较治疗前明显改善(P＜0.05),且联合组优于对照组(P＜0.05);治疗6、12个月后联合组、对照组血管性血友病因子、内皮素1水平较治疗前均明显降低(P＜0.05),血管内皮生长因子、一氧化氮水平均明显上升(P＜0.05),且联合组优于对照组(P＜0.05);联合组治疗期间急性加重人数和次数明显低于对照组(P＜0.05),两组不良反应发生率差异无统计学意义(P＞0.05).结论:茚达特罗联合噻托溴铵治疗稳定期COPD临床疗效较好且安全性良好,同时可有效改善血管内皮功能.%Objective:To investigate the effect of indacaterol combined with tiotropium in the treatment of chronic obstructive pulmonary disease (COPD) and its influence on vascular endothelial function.Methods:A total of 86 patients in the stable phase of COPD in B and C grade from March 2014 to January 2016 were enrolled and were randomly divided into control group and combination group.Control group was given indacaterol while combination group was given indacaterol combined with tiotropium.The courses of treatment in two groups were 1 year.The pulmonary function,CAT scores,vascular endothelial function before treatment and 6 and 12 months after treatment and the situation of acute exacerbation during the treatment were compared.Results:The FEV1,FVC,FEV1/FVC,IC and CAT scores between combination group and control group were significantly improved 6 and 12 months after treatment (all P ＜ 0.05) and those in combination group were better than those in control group (P ＜ 0.05).6 and 12 months after treatment,the levels of vWf and ET-1 in combination group and control group were significant lower (P ＜ 0.05) while the levels of VEGF and NO were significant higher and those in combination group were better than those in control group (P ＜ 0.05).The cases and frequency of acute exacerbation in combination group were significant lower than those in control group during the treatment (P ＜ 0.05).There was no significant difference in adverse reactions between two groups (P ＞ 0.05).Conclusion:Indacaterol combined with tiotropium can improve pulmonary function and quality of life,reduce the number of acute exacerbation with high safety and also improve the vascular endothelial function.