摘要
目的研究中等剂量二丙酸氯地米松(BDP)短疗程吸入治疗稳定期慢性阻塞性肺部疾病(COPD)是否有疗效。方法按照随机、对照、单盲的设计,30例稳定期COPD患者分类两组,分别予(1000 BDPμg/d)与安慰剂吸入治疗6周,治疗前后测定肺功能一秒钟用力呼气容积(FEV1)、血浆内皮素(ET-1)的浓度,诱导痰细胞总数,中性粒细胞(PMN)分类及ET-1浓度,并记录临床症状记分,生活质量记分。结果27例完成实验,治疗组14例临床症状改善(治疗前4.3±1.2分,治疗后3.2±1.4分,P<0.05);FEV1提高显著(治疗前2.03±0.45 L, 治疗后2.24±0.31 L, P<0.01);诱导痰中细胞总数治疗前:(246±42)×108/L治疗后:(225±33)×108/L, P<0.01),中性粒细胞分类治疗前:(75.6±6.7)%,治疗后:(71.4±6.5)%, P<0.01)均明显下降。生活质量记分、血浆ET-1浓度和诱导痰ET-1浓度均无明显改变(P均>0.05)。结论短期BDP吸入治疗稳定期COPD患者可缓解临床症状,提高肺功能,抑制气道炎性细胞浸润,但不影响生活质量和ET-1水平。
Objective: To determine whether patients with COPD have favorable responses to inhaled corticosteroids (ICS). Methods: A randomized, placebo-controlled and single-blind trail of inhaled beclomethasone dipropionate (BDP 1000 μg daily for 6 weeks) was carried out in 30 patients with stable COPD. Before and after therapy, score of clinical symptoms and score of quality of life were recorded, spirometry and levels of endothelin-1 (ET-1) in plasma and induced sputum were measured, and cytologic examination in induced sputum was taken in. Results: Compared with the placebo-group after treatment, the BDP group showed significant improvement in symptom score (P <0.05) and FEV1 (P <0.01), but not quality of life (P >05); and reduction in the number of all cells (246±42)×108/L vs (225±33) ×108/L, P <0.01), neutrophil propo tion (75.6±6.7)% vs (71.4±6.5)%, P <0.01) in induced sputum. The concentrations of ET-1 in plasma and induced sputum did not change significantly in both groups (P >0.05). Conclusions: The study suggests that the treatment with inhaled corticosteroids (1000 μg daily for 6 weeks) can improve clinical symptoms and pulmonary function, decrease inflammatory cells in airway in patients with stable COPD.
出处
《中国现代医学杂志》
CAS
CSCD
2004年第19期26-29,36,共5页
China Journal of Modern Medicine
关键词
慢性阻塞性肺部疾病
糖皮质激素
内皮素
生活质量
chronic obstructive pulmonary disease
corticosteroids
endothelin
quality of life
