CAJ | 학술논문

目的探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者联合吸入沙丁胺醇、溴化异丙托品与单独吸入沙丁胺醇后的肺功能变化差异.方法采用前瞻性方法研究43例COPD患者联合吸药后的肺通气功能变化,回顾性收集180例COPD患者经典支气管舒张试验数据作为对照,比较两组患者的支气管可逆性差异.结果联合吸药组总体和GOLDⅡ级患者吸药30 min后支气管舒张试验阳性率为34.9%和43.5%,显著大于单独吸药组总体和GOILD Ⅱ级患者的阳性率17.2%和18.4%(P＜0.05).联合吸药组吸药30 min后FEV_1改善率≥20.0%和＜10.0%的患者比例差异无统计学意义(P>0.05),分别为37.2%和39.5%,但单独吸药组FEV_1改善率≥20.0%和＜10.0%的患者比例差异有统计学意义(P＜0.001),分别为17.8%和53.9%.两组中FEV_1改善率≥20.0%的患者比例差异有统计学意义(P＜0.05).联合吸药组总体和GOLDⅡ级患者吸药30 min后的△FEV_1和△FVC显著大于单独吸药组总体和GOLDⅡ级患者吸药后的相应值(P＜0.05).两组患者的△FEV_1与△FVC均呈显著正相关,随COPD严重度增加,其相关性在联合吸药组呈增强趋势,而在单独吸药组呈减弱趋势.结论 COPD患者联合吸入沙丁胺醇和溴化异丙托品比单独吸入沙丁胺醇更具有明显的支气管舒张可逆性,并且舒张作用的时效性在联合吸药组更长.
목적 탐토만성조새성폐질병(chronic obstructive pulmonary disease,COPD)환자연합흡입사정알순、추화이병탁품여단독흡입사정알순후적폐공능변화차이.방법 채용전첨성방법 연구43례COPD환자연합흡약후적폐통기공능변화,회고성수집180례COPD환자경전지기관서장시험수거작위대조,비교량조환자적지기관가역성차이.결과 연합흡약조총체화GOLDⅡ급환자흡약30 min후지기관서장시험양성솔위34.9%화43.5%,현저대우단독흡약조총체화GOILD Ⅱ급환자적양성솔17.2%화18.4%(P＜0.05).연합흡약조흡약30 min후FEV_1개선솔≥20.0%화＜10.0%적환자비례차이무통계학의의(P>0.05),분별위37.2%화39.5%,단단독흡약조FEV_1개선솔≥20.0%화＜10.0%적환자비례차이유통계학의의(P＜0.001),분별위17.8%화53.9%.량조중FEV_1개선솔≥20.0%적환자비례차이유통계학의의(P＜0.05).연합흡약조총체화GOLDⅡ급환자흡약30 min후적△FEV_1화△FVC현저대우단독흡약조총체화GOLDⅡ급환자흡약후적상응치(P＜0.05).량조환자적△FEV_1여△FVC균정현저정상관,수COPD엄중도증가,기상관성재연합흡약조정증강추세,이재단독흡약조정감약추세.결론 COPD환자연합흡입사정알순화추화이병탁품비단독흡입사정알순경구유명현적지기관서장가역성,병차서장작용적시효성재연합흡약조경장.
Objective To investigate the different changes of pulmonary ventilation function after inhaled both salbutamol and ipratropium bromide and after inhaled single salbutamol in patients with chronic obstructive pulmonary disease (COPD).Methods The pulmonary function after inhaled combined bronchodilators in 43 patients with COPD were analyzed by prospective study,and as control,the classic bronchodilation test data of 180 patients with COPD were retrospectively collected.Results The positive rates of hronchodilation test after inhaled combined bronchodilators 30 minutes in combined bronchodilators group and its'GOLD Ⅱ patients were 34.9% and 43.5%,which significantly greater than 17.25% and 18.4% of single bronchodilators group and its GOLD Ⅱ patients (P＜0.05).The percentages of patients whose FEV_1 improvement rate≥20.0% and ＜10.0% were 37.2% and 39.5% after inhaled combined bronchodilators 30 minutes in combined bronchodilators group (P>0.05),while in single bronchodilator group the percentages were respectively 17.8% and 53.9% in same FEV_1 improvement rate ranges (P＜0.05).The percentages of patients in two groups whose FEV_1 improvement rate 20.0% were significantly different each other (P＜0.001).△FEV_1 and △FVC after inhaled combined broncbodilators 30 minutes in combined broncbodilators group and its GOLDⅡ patients were greater than those of single bronchodilator group and its GOLDⅡ patients (P＜0.05).There were significant positive correlation between △FEV_1 and △FVC in two groups,along with the progression of COPD,the correlation gradually strengthened in combined bronchodilators group but gradually weakened in single bronchodilator group.Conclusions The patient with COPD had more obvious bronchial reversibility after inhaled both salbutamol and ipratropium bromide than after inhaled single salbutamol,moreover,the duration of drug effect were longer in combined bronchodilators group patients.