中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2014年
20期
66-68
,共3页
慢性阻塞性肺疾病%噻托溴铵%超敏C反应蛋白%肿瘤坏死因子-α
慢性阻塞性肺疾病%噻託溴銨%超敏C反應蛋白%腫瘤壞死因子-α
만성조새성폐질병%새탁추안%초민C반응단백%종류배사인자-α
Chronic obstructive pulmonary disease%Tiotropium%High sensitive C-reactive protein%Tumor necrosis factor-α
目的：探讨噻托溴铵对慢性阻塞性肺疾病(COPD)稳定期患者血清超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)水平及肺功能的影响。方法选取2012年8月~2013年9月宁波市北仑区人民医院呼吸科治疗的COPD稳定期患者70例，随机分为观察组(n=35)和对照组(n=35)。对照组患者予以茶碱缓释片口服，0.1 g/次，2次/d，连用16周。观察组患者予以噻托溴铵干粉剂1粒/次，1次/d，睡前吸入，连用16周。观察两组治疗前和治疗16周后血清hs-CRP、TNF-α及肺功能的变化。结果治疗16周后，观察组与对照组患者血清hs-CRP、TNF-α水平[(1.07±0.23)mg/L，(1.45±0.27)ng/mL；(1.42±0.31)mg/L，(2.16±0.45)ng/mL]均较前[(2.05±0.46)mg/L，(2.92±0.52)ng/mL；(1.97±0.45)mg/L，(2.87±0.57)ng/mL]明显下降(t =3.02、3.17、2.39、2.31，P<0.01或P<0.05)，且观察组下降幅度明显大于对照组(t =2.27、2.45，P<0.05)；同时观察组与对照组患者治疗后用力肺活量(FVC)、第1秒用力呼气量(FEV1)和FEV1/FVC[(1.77±0.34)L，(1.21±0.25)L，(0.70±0.19)；(1.58±0.32)L，(0.99±0.23)L，(0.63±0.15)]均较前[(1.41±0.24)L，(0.80±0.15)L，(0.57±0.12)；(1.42±0.26)L，(0.79±0.18)L，(0.56±0.13)]明显提高(t =2.45、2.89、2.44、2.16、2.41、2.18，P<0.05或P<0.01)，且观察组提高幅度明显大于对照组(t =2.18、2.37、2.15，P<0.05)。结论噻托溴铵吸入治疗COPD稳定期具有较好的效果，能明显改善患者的肺功能，其作用机制与其能降低血清炎症因子hs-CRP、TNF-α水平，抑制慢性炎性反应过程密切相关。
目的：探討噻託溴銨對慢性阻塞性肺疾病(COPD)穩定期患者血清超敏C反應蛋白(hs-CRP)和腫瘤壞死因子-α(TNF-α)水平及肺功能的影響。方法選取2012年8月~2013年9月寧波市北崙區人民醫院呼吸科治療的COPD穩定期患者70例，隨機分為觀察組(n=35)和對照組(n=35)。對照組患者予以茶堿緩釋片口服，0.1 g/次，2次/d，連用16週。觀察組患者予以噻託溴銨榦粉劑1粒/次，1次/d，睡前吸入，連用16週。觀察兩組治療前和治療16週後血清hs-CRP、TNF-α及肺功能的變化。結果治療16週後，觀察組與對照組患者血清hs-CRP、TNF-α水平[(1.07±0.23)mg/L，(1.45±0.27)ng/mL；(1.42±0.31)mg/L，(2.16±0.45)ng/mL]均較前[(2.05±0.46)mg/L，(2.92±0.52)ng/mL；(1.97±0.45)mg/L，(2.87±0.57)ng/mL]明顯下降(t =3.02、3.17、2.39、2.31，P<0.01或P<0.05)，且觀察組下降幅度明顯大于對照組(t =2.27、2.45，P<0.05)；同時觀察組與對照組患者治療後用力肺活量(FVC)、第1秒用力呼氣量(FEV1)和FEV1/FVC[(1.77±0.34)L，(1.21±0.25)L，(0.70±0.19)；(1.58±0.32)L，(0.99±0.23)L，(0.63±0.15)]均較前[(1.41±0.24)L，(0.80±0.15)L，(0.57±0.12)；(1.42±0.26)L，(0.79±0.18)L，(0.56±0.13)]明顯提高(t =2.45、2.89、2.44、2.16、2.41、2.18，P<0.05或P<0.01)，且觀察組提高幅度明顯大于對照組(t =2.18、2.37、2.15，P<0.05)。結論噻託溴銨吸入治療COPD穩定期具有較好的效果，能明顯改善患者的肺功能，其作用機製與其能降低血清炎癥因子hs-CRP、TNF-α水平，抑製慢性炎性反應過程密切相關。
목적：탐토새탁추안대만성조새성폐질병(COPD)은정기환자혈청초민C반응단백(hs-CRP)화종류배사인자-α(TNF-α)수평급폐공능적영향。방법선취2012년8월~2013년9월저파시북륜구인민의원호흡과치료적COPD은정기환자70례，수궤분위관찰조(n=35)화대조조(n=35)。대조조환자여이다감완석편구복，0.1 g/차，2차/d，련용16주。관찰조환자여이새탁추안간분제1립/차，1차/d，수전흡입，련용16주。관찰량조치료전화치료16주후혈청hs-CRP、TNF-α급폐공능적변화。결과치료16주후，관찰조여대조조환자혈청hs-CRP、TNF-α수평[(1.07±0.23)mg/L，(1.45±0.27)ng/mL；(1.42±0.31)mg/L，(2.16±0.45)ng/mL]균교전[(2.05±0.46)mg/L，(2.92±0.52)ng/mL；(1.97±0.45)mg/L，(2.87±0.57)ng/mL]명현하강(t =3.02、3.17、2.39、2.31，P<0.01혹P<0.05)，차관찰조하강폭도명현대우대조조(t =2.27、2.45，P<0.05)；동시관찰조여대조조환자치료후용력폐활량(FVC)、제1초용력호기량(FEV1)화FEV1/FVC[(1.77±0.34)L，(1.21±0.25)L，(0.70±0.19)；(1.58±0.32)L，(0.99±0.23)L，(0.63±0.15)]균교전[(1.41±0.24)L，(0.80±0.15)L，(0.57±0.12)；(1.42±0.26)L，(0.79±0.18)L，(0.56±0.13)]명현제고(t =2.45、2.89、2.44、2.16、2.41、2.18，P<0.05혹P<0.01)，차관찰조제고폭도명현대우대조조(t =2.18、2.37、2.15，P<0.05)。결론새탁추안흡입치료COPD은정기구유교호적효과，능명현개선환자적폐공능，기작용궤제여기능강저혈청염증인자hs-CRP、TNF-α수평，억제만성염성반응과정밀절상관。
Objective To discuss influence of Tiotropium Bromide on serum high sensitive C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) levels and lung function of patients with stable chronic obstructive pulmonary disease (COPD). Methods 70 cases of patients with stable COPD, who were treated in Pneumology Department, Beilun District People's Hospital in Ningbo City from August 2012 to September 2013 were selected and divided into observa-tion group (n=35) and control group (n=35) at random. The patients in control group were given Theo-Dur through the mouth, 0.1 g per time, twice a day for 16 weeks. The patients in observation group were given Tiotropium Bromide Dry Powder, one tablet per time, which was inhaled before going to bed for 16 weeks. The changes of serum hs-CRP, TNF-αand lung function of patients in two groups were observed before and 16 weeks after medical treatment. Results After 16 weeks' medical treatment, serum hs-CRP and TNF-α levels of patients in observation group and control group [(1.07±0.23) mg/L, (1.45±0.27) ng/mL; (1.42±0.31) mg/L, (2.16±0.45) ng/mL] obviously declined than before [(2.05±0.46) mg/L, (2.92±0.52) ng/mL;(1.97±0.45) mg/L, (2.87±0.57) ng/mL] (t=3.02, 3.17, 2.39, 2.31, P<0.01 or P<0.05), and the declining rate in observation group was much higher than that in control group (t = 2.27, 2.45, P < 0.05). Meanwhile, FVC, FEV1 and FEV1/FVC of patients in observation group and control group [(1.77±0.34) L, (1.21±0.25) L,(t =2.45, 2.89, 2.44, 2.16, 2.41, 2.18, P< 0.05 or P<0.01), and the rising rate in observation group was much higher than that in control group (t =2.18, 2.37, 2.15, P<0.05). Conclusion The inhalation of Tiotropium has reliable cura-tive effect on stable COPD, and can obviously improve the lung function of patients, whose mechanism of action has close effect on reducing the hs-CRP and TNF-α levels of serum inflammatory factors, and inhibiting the chronic in-flammatory process.
