布地奈德联合福莫特罗治疗慢性阻塞性肺疾病急性加重期的临床疗效及其对炎性递质的影响研究

摘要

Objective To investigate the clinical effect of budesonide combined with formoterol on acute exacerbation of chronic obstructive pulmonary disease( AEcOPD) and its impact on inflammatory mediators. Methods A total of 123 AEcOPD patients admitted to the Yuebei People's Hospital Affiliated to Medical School of Shantou University were selected from February 2010 to August 2014,and they were randomly divided into treatment group(n = 60) and control group( n = 63). Treatment group was given budesonide combined with formoterol,while control group was given budesonide only. Before treatment and 7 days after treatment,sputum levels of TNF - α and IL - 8,Borg score,PacO2 and PaO2 ,FEV1% were compared between the two groups. Results No statistically significant differences of sputum levels of TNF - α or IL - 8,Borg score, PacO2 or PaO2 ,FEV1% was found between the two groups before treatment( P > 0. 05);after 7 days of treatment,sputum levels of TNF - α and IL - 8,Borg score,PacO2 of treatment group were lower than those of control group,while PaO2 and FEV1% were higher(P < 0. 05). Conclusion Budesonide combined with formoterol has certain clinical effect on AEcOPD, can effectively improve lung function and relieve clinical symptoms, reduce the release of inflammatory mediators and inflammatory reactions.%目的：探讨布地奈德联合福莫特罗治疗慢性阻塞性肺疾病急性加重期（AEcOPD）的临床疗效及其对炎性递质的影响。方法选择汕头大学医学院附属粤北人民医院呼吸科2010年2月—2014年8月收治的 AEcOPD 患者123例，将患者随机分为治疗组（n =60）和对照组（n =63）。治疗组患者给予布地奈德联合福莫特罗治疗，对照组仅给予布地奈德治疗。治疗前及治疗7 d 后检测两组患者痰液中肿瘤坏死因子α（TNF -α）和白介素8（IL -8）水平、呼吸困难评分（Borg 评分）、动脉血气分析〔动脉血二氧化碳分压（PacO2）、动脉血氧分压（PaO2）〕及肺功能〔第一秒用力呼气容积（FEV1）占基线值百分比〕。结果两组患者治疗前 FEV1占基线值百分比、PacO2、PaO2、Borg 评分及痰液中 TNF -α 和 IL -8 水平比较，差异无统计学意义（P ＞0.05）；治疗组治疗后 FEV1占基线值百分比和 PaO2高于对照组，PacO2、Borg 评分及痰液中 TNF -α 和 IL -8 水平低于对照组（P ＜0.05）。结论布地奈德联合福莫特罗治疗 AEcOPD 疗效确切，能有效改善患者肺功能及临床症状，且能减少炎性递质的释放，从而使患者炎性反应得到缓解。