CAJ | 학술논문

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18 μg,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.
목적 탐토노년중중도은정기만성조새성폐질병(COPD)환자응용새탁추안(흡입제량18 μg,1차/d)적료효화안전성. 방법 재중중도은정기96례COPD환자,련속3년응용새탁추안,매3개월검측폐공능제1초용력호흡기량점예계치적백분비(FEV1)화용력폐활량(FVC),골· 교치호흡문권계분( SGRQ)평고생활질량,관찰급성가중적발생솔급용약적불량반응. 결과 경련속3년적치료관찰,여대조조비교,새탁추안치료조용약후적FEV1교기선치현저증가,FEV1증가0.26 L(P<0.01),병차중도COPD환자폐공능개선명현,치료조재6개월후폐공능하강추세명현변완. 새탁추안조환자SGRQ평분저우대조조,재중도치료후적제3개월,새탁추안치료조SGRQ총평분교기선저료6.85,대조조SGRQ총평분교기선저료1.14,SGRQ총평분치료조교대조조명현개선(P<0.01);재중도환자중치료6 개월후 SGRQ 총평분치료조교대조조비교유명현개선.COPD급성가중솔치료조여대조조지비위0.75(95% CI 0.58~0.96;P<0.05). 재안전지표방면치료조여대조조몰유현저차이. 결론 새탁추알대우개선폐통기공능、건강상태급강저급성발작빈솔등방면현시출료독특적장처,차내수성량호,시목전은정기COPD환자적유효약물.
Objective To investigate the curative effect and safety of Tiotropium Bromide (inhalation, 18μg, once daily) in elder patients with chronic obstructive pulmonary disease(COPD).Methods 96 patients with stable COPD given Tiotropium Bromide for 3con-secutive 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 mod-erate COPD after 6 months treatment compare with that of control group.The acute exacerbation ratio of treatment and control group was 0.75 (95%CI 0.58~0.96;P<0.05).There was no significant difference between treatment group and control group in safety index aspect.Con-clusions 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.