2022 年第 9 期 第 17 卷

布地奈德福莫特罗粉吸入剂联合噻托溴铵粉吸入剂在老年急性加重期慢性阻塞性肺疾病患者中的应用效果观察

Effect of budesonide and formoterol fumarate powder inhalation combined with tiotropium bromide powder for inhalation on elderly patients with acute exacerbation of chronic obstructive pulmonary disease

作者：崔可慧林震宇谷秀

英文作者：Cui Kehui Lin Zhenyu Gu Xiu

单位：中国医科大学附属第四医院第一呼吸与危重症医学科，沈阳110034

英文单位：The First Department of Respiratory and Critical Care Medicine the Fourth Affiliated Hospital of China Medical University Shenyang 110034 China

关键词：慢性阻塞性肺疾病；布地奈德福莫特罗粉吸入剂；噻托溴铵粉吸入剂

英文关键词：Chronicobstructivepulmonarydisease;Budesonideandformoterolfumaratepowderinhalation;Tiotropiumbromidepowderforinhalation

• 摘要：

• 目的 探讨布地奈德福莫特罗粉吸入剂联合噻托溴铵粉吸入剂治疗老年急性加重期慢性阻塞性肺疾病（COPD）的效果及对患者血清氧化应激分子、补体C1q肿瘤坏死因子相关蛋白5（CTRP5）及分泌型卷曲相关蛋白5（SFRP5）水平的影响。方法  以中国医科大学附属第四医院2020年6月至2021年8月诊治的140例老年急性加重期COPD患者为研究对象。完全随机将140例患者分为对照组和观察组，各70例。对照组在常规治疗的基础上接受噻托溴铵粉吸入剂治疗，观察组在常规治疗的基础上接受布地奈德福莫特罗粉吸入剂联合噻托溴铵粉吸入剂治疗。比较2组患者的肺功能、临床效果、血清氧化应激分子［过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、丙二醛］及CTRP5和SFRP5水平的变化。结果  治疗后，2组第1秒用力呼气容积(FEV1)、用力肺活量（FVC）水平及FEV1/FVC比值均高于治疗前，且观察组均高于对照组，差异均有统计学意义（均P<0.05）。观察组总有效率高于对照组［82.9%（58/70）比67.1%（47/70）］，差异有统计学意义（P<0.05）。治疗后，2组CAT、SOD及SFRP5水平均高于治疗前且观察组均高于对照组，丙二醛及CTRP5水平均低于治疗前且观察组均低于对照组，差异均有统计学意义（均P<0.05）。结论 布地奈德福莫特罗粉吸入剂联合噻托溴铵粉吸入剂治疗老年急性加重期COPD可使患者肺功能明显改善，异常的血清氧化应激分子、CTRP5及SFRP5水平明显恢复。

• Objective  To study the efficacy of budesonide and formoterol fumarate powder inhalation combined with tiotropium bromide powder for inhalation on elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD), and its effects on serum levels of oxidative stress molecules, complement C1q/tumor necrosis factor-related protein 5(CTRP5) and secreted frizzled related protein 5(SFRP5). Methods  Totally 140 elderly patients with acute exacerbation of COPD admitted to the Fourth Affiliated Hospital of China Medical University from June 2020 to August 2021 were enrolled. Patients were randomly divided into control group and observation group, with 70 cases in each group. The control group received tiotropium bromide powder for inhalation on the basis of conventional treatment, and the observation group were treated with budesonide and formoterol fumarate powder inhalation combined with tiotropium bromide powder for inhalation on the basis of conventional treatment. The pulmonary function, clinical effects, serum levels of oxidative stress molecules［catalase, superoxide dismutase(SOD), malondialdehyde］, CTRP5 and SFRP5 before and after treatment were compared between the two groups. Results  After treatment, forced expiratory volume in the first second(FEV1), forced vital capacity(FVC) and FEV1/FVC ratio in both groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group(all P<0.05). The total effective rate of the observation group was higher than that of the control group［82.9%(58/70) vs 67.1%(47/70)］(P<0.05). After treatment, levels of catalase, SOD and SFRP5 in the two groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group; levels of malondialdehyde and CTRP5 in both groups were lower than those before treatment, and the levels in the observation group were lower than those in the control group(all P<0.05). Conclusion  Budesonide and formoterol fumarate powder inhalation combined with tiotropium bromide powder for inhalation can significantly improve lung function in elderly patients with acute exacerbation of COPD, and restore abnormal serum levels of oxidative stress molecules, CTRP5 and SFRP5.