摘要
目的探讨老年中重度稳定期慢性阻塞性肺疾病(COPD)患者应用噻托溴铵(吸入剂量18μg,1次/d)的疗效和安全性。方法在中重度稳定期96例COPD患者,连续3年应用噻托溴铵,每3个月检测肺功能第1秒用力呼吸气量占预计值的百分比(FEV1)和用力肺活量(FVC),圣·乔治呼吸问卷计分(SGRQ)评估生活质量,观察急性加重的发生率及用药的不良反应。结果经连续3年的治疗观察,与对照组比较,噻托溴铵治疗组用药后的FEV1较基线值显著增加,FEV1增加0.26 L(P<0.01),并且重度COPD患者肺功能改善明显,治疗组在6个月后肺功能下降趋势明显变缓。噻托溴铵组患者SGRQ评分低于对照组,在重度治疗后的第3个月,噻托溴铵治疗组SGRQ总评分较基线低了6.85,对照组SGRQ总评分较基线低了1.14,SGRQ总评分治疗组较对照组明显改善(P<0.01);在中度患者中治疗6个月后SGRQ总评分治疗组较对照组比较有明显改善。COPD急性加重率治疗组与对照组之比为0.75(95%CI 0.58~0.96;P<0.05)。在安全指标方面治疗组与对照组没有显著差异。结论噻托溴胺对于改善肺通气功能、健康状态及降低急性发作频率等方面显示出了独特的长处,且耐受性良好,是目前稳定期COPD患者的有效药物。
Objective To investigate the curative effect and safety of Tiotropium Bromide( inhalation,18 μg,once daily) in elder patients with chronic obstructive pulmonary disease( COPD). Methods 96 patients with stable COPD given Tiotropium Bromide for 3 consecutive years were enrolled. Pulmonary function test,SGRQ for life quality and 6 minutes-walking test were evaluated every 3 months,the incident of exacerbation and adverse drug reactions were also observed. Results Compared with that of control group,the level of FEV1 was significantly increased after 3 years’ treatment in treatment group,the level of FEV1 was increased by 0. 62 L,lung function of patients with severe COPD was improved more obviously. Decline of lung function in treatment group was slower obviously after 6 months. The SGRQ total score of treatment group was lower than that of control group. For severe COPD patients,SGRQ total score was decreased by 6. 85 compared to baseline in treatment group,versus 1. 14 in control group( P < 0. 01). Same improvement of SGRQ was also appeared for patient with moderate COPD after 6 months treatment compare with that of control group. The acute exacerbation ratio of treatment and control group was0. 75( 95% CI 0. 58 ~ 0. 96; P < 0. 05). There was no significant difference between treatment group and control group in safety index aspect. Conclusions Tiotropium Bromide displays unique advantages not only in improving pulmonary ventilation function but also in improving patients’ life quality and reducing acute seizure frequency. It is an effective treatment medicine for elder patients with stable COPD.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2015年第17期4916-4918,共3页
Chinese Journal of Gerontology
基金
国家十一五支撑项目(2007BAI24B04)
沈阳市科技局(F12-277-1-71)
辽宁省科技厅基金(2013225303)
关键词
慢性阻塞性肺病
噻托溴胺
Chronic obstructive pulmonary disease
Tiotropium Bromide
