基于一氧化碳弥散量与深吸气量分组的COPD患者对吸入布地奈德福莫特罗的反应比较

发布时间：2018-06-28 06:04

本文选题：肺疾病 + 慢性阻塞性　；参考：《中国全科医学》2015年23期

【摘要】：目的比较不同一氧化碳弥散量(DLCO)和深吸气量(IC)的COPD患者对吸入布地奈德福莫特罗治疗的反应。方法选取2012年6月—2014年6月于沧州市中心医院就诊的稳定期中重度COPD患者105例为研究对象,患者经过2周的清洗期,均给予3个月的布地奈德福莫特罗320μg/9μg治疗。根据治疗前DLCO占预计值百分比和IC占预计值百分比,将患者分为DLCO及IC均正常组(A组,10例)、DLCO减低且IC正常组(B组,18例)、DLCO正常且IC减低组(C组,22例)、DLCO及IC均减低组(D组,55例)。收集患者临床特征资料,采用胸部高分辨率CT进行肺气肿视觉评分。比较各组治疗前后第1秒用力呼气末容积(FEV1)、用力肺活量(FVC)及COPD评估测试(CAT)评分的变化。结果各组男性比例、年龄、吸烟指数、CAT评分、急性加重次数、FVC、FEV1占预计值百分比、FVC占预计值百分比和肺气肿视觉评分比较,差异有统计学意义(P0.05),其中,D组CAT评分高于其他各组;D组急性加重次数多于A组;C组FVC高于其他各组,D组FVC占预计值百分比低于其他各组;D组FEV1占预计值百分比低于A组和B组;B组和D组肺气肿视觉评分高于A组和C组(P0.05)。各组治疗3个月后FEV1、FVC及CAT评分的变化比较,差异均有统计学意义(P0.05);其中,C组FEV1变化的绝对值和相对值高于其他各组,D组FEV1变化的相对值高于B组;C组FVC变化的绝对值高于其他各组,FVC变化的相对值高于B组和D组;C组CAT评分变化大于B组和D组(P0.05)。A组和C组出现咽部不适、声音嘶哑各1例,D组出现口腔真菌感染1例,经治疗后均好转。结论可依据DLCO联合IC对COPD进行分型,DLCO正常且IC减低的患者对布地奈德福莫特罗的治疗反应较好。
[Abstract]:Objective to compare the response of COPD patients with different carbon monoxide dispersion (DLCO) and deep inspiratory capacity (IC) to inhaled budesonide formoterol. Methods 105 patients with moderate and severe COPD who were admitted to Cangzhou Central Hospital from June 2012 to June 2014 were treated with budesonide formoterol 320 渭 g / 9 渭 g for 3 months after two weeks of cleaning. According to the percentage of DLCO to predicted value and the percentage of IC to predicted value before treatment, the patients were divided into two groups: normal DLCO and IC (n = 10) and normal IC (n = 18). The clinical features of the patients were collected and the visual score of emphysema was evaluated by chest high-resolution CT. Forced end expiratory volume (FEV1) forced vital capacity (FVC) and COPD assessment (cat) were compared before and after treatment. Results the ratio of male, age, smoking index and cat score, the percentage of FVC and FEV1 in predicted value and the visual score of emphysema were compared. The cat score in group D was higher than that in group A (P 0.05), and the percentage of FVC in group C was higher than that in group A (P 0.05). The percentage of FVC in group D was lower than that in group D and the percentage of FEV1 in predicted value in group D was lower than that in group D. The visual scores of emphysema in group A and group B were higher than those in group A and group C (P0.05). Comparison of FEV1 FVC and cat scores after 3 months of treatment in each group. The absolute and relative values of FEV1 in group C were higher than those in group D (P 0.05), and the absolute value of FVC in group C was higher than that in group B (P 0.05), and that in group C was higher than that in group B. The changes of cat score in group C and group D were greater than those in group B and group D (P0.05). One case of oral fungal infection occurred in group D with hoarseness, all of which were improved after treatment. Conclusion the patients who can classify COPD according to DLCO and IC have better response to budesonide formoterol if DLCO is normal and IC is decreased.
【作者单位】：河北省沧州市中心医院呼吸内一科;
【分类号】：R563.9

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