中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2012年
11期
833-835
,共3页
肺疾病,慢性阻塞性%高血压,肺性%噻托嗅铵
肺疾病,慢性阻塞性%高血壓,肺性%噻託嗅銨
폐질병,만성조새성%고혈압,폐성%새탁후안
Pulmonary disease,chronic obstructive%Hypertension,pulmonary%Tiotropium
目的 观察噻托嗅铵对慢性阻塞性肺疾病(COPD)合并肺动脉高压患者的影响.方法 收集2010年1月至2011年6月经呼吸内科治疗后的76例合并肺动脉高压的COPD稳定期患者,其中男51例,女25例.按照随机数字表法分为试验组和对照组,对照组38例(男25例,女13例),规律吸入福莫特罗干粉吸入剂(每吸4.5 μg,每日2吸)、口服茶碱缓释片(0.1g,每日2次),并根据病情需要使用抗感染药物及黏痰溶解剂；试验组38例(男26例,女12例),在上述治疗基础上,每日一次吸入噻托嗅铵干粉18 μg.观察16周后所有患者6 min步行距离、心脏彩色超声间接测定肺动脉收缩压及喘息症状评分的变化.将6 min步行距离和肺动脉收缩压的变化作为主要终点,同时观察药物的安全性和耐受性,并对试验数据进行意向性分析和符合方案数据分析.结果 第16周随访观察结束时,试验组患者肺动脉收缩压下降[(17.4±4.8)mm Hg(1 mm Hg=0.133 kPa)]；6 min步行距离增加(45±16)m；喘息症状评分降低(1.6±0.7)分,与对照组的差异有统计学意义(P＜0.05),且未发生明显不良反应.结论 合并肺动脉高压的COPD稳定期患者吸入噻托嗅铵治疗,可不同程度降低肺动脉压力、提高运动耐量、改善喘息症状,并有良好的耐受性.
目的 觀察噻託嗅銨對慢性阻塞性肺疾病(COPD)閤併肺動脈高壓患者的影響.方法 收集2010年1月至2011年6月經呼吸內科治療後的76例閤併肺動脈高壓的COPD穩定期患者,其中男51例,女25例.按照隨機數字錶法分為試驗組和對照組,對照組38例(男25例,女13例),規律吸入福莫特囉榦粉吸入劑(每吸4.5 μg,每日2吸)、口服茶堿緩釋片(0.1g,每日2次),併根據病情需要使用抗感染藥物及黏痰溶解劑；試驗組38例(男26例,女12例),在上述治療基礎上,每日一次吸入噻託嗅銨榦粉18 μg.觀察16週後所有患者6 min步行距離、心髒綵色超聲間接測定肺動脈收縮壓及喘息癥狀評分的變化.將6 min步行距離和肺動脈收縮壓的變化作為主要終點,同時觀察藥物的安全性和耐受性,併對試驗數據進行意嚮性分析和符閤方案數據分析.結果 第16週隨訪觀察結束時,試驗組患者肺動脈收縮壓下降[(17.4±4.8)mm Hg(1 mm Hg=0.133 kPa)]；6 min步行距離增加(45±16)m；喘息癥狀評分降低(1.6±0.7)分,與對照組的差異有統計學意義(P＜0.05),且未髮生明顯不良反應.結論 閤併肺動脈高壓的COPD穩定期患者吸入噻託嗅銨治療,可不同程度降低肺動脈壓力、提高運動耐量、改善喘息癥狀,併有良好的耐受性.
목적 관찰새탁후안대만성조새성폐질병(COPD)합병폐동맥고압환자적영향.방법 수집2010년1월지2011년6월경호흡내과치료후적76례합병폐동맥고압적COPD은정기환자,기중남51례,녀25례.안조수궤수자표법분위시험조화대조조,대조조38례(남25례,녀13례),규률흡입복막특라간분흡입제(매흡4.5 μg,매일2흡)、구복다감완석편(0.1g,매일2차),병근거병정수요사용항감염약물급점담용해제；시험조38례(남26례,녀12례),재상술치료기출상,매일일차흡입새탁후안간분18 μg.관찰16주후소유환자6 min보행거리、심장채색초성간접측정폐동맥수축압급천식증상평분적변화.장6 min보행거리화폐동맥수축압적변화작위주요종점,동시관찰약물적안전성화내수성,병대시험수거진행의향성분석화부합방안수거분석.결과 제16주수방관찰결속시,시험조환자폐동맥수축압하강[(17.4±4.8)mm Hg(1 mm Hg=0.133 kPa)]；6 min보행거리증가(45±16)m；천식증상평분강저(1.6±0.7)분,여대조조적차이유통계학의의(P＜0.05),차미발생명현불량반응.결론 합병폐동맥고압적COPD은정기환자흡입새탁후안치료,가불동정도강저폐동맥압력、제고운동내량、개선천식증상,병유량호적내수성.
Objective To explore the curative effect of inhaled tiotropium upon patients of stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 76 patients (Male/Female =51/25) of stable COPD complicated with pulmonary hypertension were recruited from January 2010 to June 2011.According to table of random digit,they were divided into test group (n =38,M/F =26/12) and control group (n =38,M/F =25/13).Patients of control group inhaled formoterol powder 4.5 μg bid,took oral theophylline sustained-release tablets 0.1 g hid.According to the demand of patient's condition,anti-infective agents and sticky phlegm lyticagent were used.Patients of test group inhaled tiotropium dry powder (18 μg,qd) in addition to the above regimen.All changes in six-minute walk test (SMWT),pulmonary arterial systolic pressure and panting symptom score were recorded at the end of 16 weeks and compared with the baseline.The primary endpoint was the changes in exercise capacity as assessed by SMWT and pulmonary arterial systolic pressure.Safety and tolerance were also investigated.Intent-to-treat and per-protocol analyses were performed.Results After a follow-up period of 16 weeks,both pulmonary arterial systolic pressure and panting symptom score decreased and SMWT walking distance increased (45 ± 16) m in the test group.Compared with the control group,the difference had statistical significance (P ＜ 0.05) and obvious adverse reaction did not occur.Conclusions For patients of stable COPD complicated with pulmonary hypertension,inhaled tiotropium dry powder decreases pulmonary pressure to various extents and improves exercise tolerance and panting symptom.And tolerance is satisfactory.
