噻托溴銨治療慢性阻塞性肺疾病患者的臨床療效及安全性

覃建民++唐艷媚++計貞++盧劍??

【摘要】目的探討噻托溴銨治療慢性阻塞性肺疾病（COPD）患者的臨床療效及安全性。

方法將94例COPD患者隨機分為觀察組48例和對照組46例，對照組給予常規治療，觀察組給予常規治療加用噻托溴銨吸入治療，觀察兩組患者肺功能變化及用藥過程的不良反應，并評價臨床療效。

結果經治療4周后、8周后，觀察組的臨床療效均明顯優于對照組（P<0.01）。治療前兩組患者第一秒用力呼氣容積（FEV1）、用力肺活量（FVC）、FEV1/FVC比較差異均無統計學意義（P>0.05）。與治療前相比較，觀察組經治療4周后、8周后FEV1、FVC、FEV1/FVC均逐步升高（P<0.01），對照組經治療4周后、8周后FVC、FEV1/FVC均逐步升高（P<0.05或0.01）。治療4周后、8周后觀察組的FEV1、FVC、FEV1/FVC均高于對照組（P<0.01）。用藥期間兩組均未發生明顯不良反應。

結論噻托溴銨能明顯改善COPD患者肺功能、提高治療效果，且無明顯不良反應。

【關鍵詞】噻托溴銨；慢性阻塞性肺疾病；臨床療效；安全性

中圖分類號：R563文獻標識碼：ADOI：10.3969/j.issn.10031383.2017.01.014

Clinical efficacy and safety of tiotropium bromide for patients with chronic obstructive pulmonary disease

[HJ2][HJ]

QIN Jianmin，TANG Yanmei，JI Zhen，LU Jian

（The First Peoples Hospital of Hechi，Hechi 546300，China）

[HJ2][HJ]

【Abstract】ObjectiveTo explore clinical efficacy and safety of tiotropium bromide for patients with chronic obstructive pulmonary disease（COPD）.

MethodsA total of 94 patients with COPD were randomly divided into observation group（n=48） and control group（n=46）.The control group were treated with conventional therapy，and the observation group were treated by conventional therapy combined with tiotropium bromide.The changes of pulmonary function and adverse reactions of the two groups were observed，and the clinical effects were evaluated.

ResultsAfter 4 weeks and 8 weeks of treatment，the clinical effect in the observation group was significantly better than that in the control group（P<0.01）.Difference of forced expiatory volume in the first second（FEV1），forced vital capacity（FVC） and FEV1/FVC of the two groups was not statistically significant（P>0.05）.Compared with those before treatment，FEV1， FVC and FEV1/FVC of the observation group increased gradually （P<0.01），so did FVC and FEV1/FVC of the control group（P<0.05 or 0.01）.In addition，after 4 weeks and 8 weeks of treatment，FEV1，FVC and FEV1/FVC of the observation group were all significantly higher than those of the control group（P<0.01）.There were no obvious adverse reactions in the two groups during treatment.

ConclusionTiotropium bromide can obviously improve pulmonary function and raise the clinical effects for patients with COPD，it has no severe adverse reactions.

【Key words】tiotropium bromide；COPD；clinical effect；safety

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是以氣流受限不完全可逆為特點的臨床常見呼吸系統疾病，COPD發病率較高，以老年人多見，患者肺功能往往呈現漸進性下降，嚴重影響患者生活質量，甚至可危及生命[1]。抗膽堿藥物在COPD患者的治療中越來越受到關注，以往的抗膽堿能藥物半衰期較短，需多次給藥，而噻托溴銨是一種新型長效吸入性抗膽堿能藥物，選擇性持久作用于支氣管M型受體，從而持續有效地改善患者呼吸困難癥狀[2]。筆者就噻托溴銨治療COPD患者的臨床療效及安全性進行分析，報告如下。