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目的:比较异丙托溴铵气雾剂、噻托溴铵干粉剂治疗轻、中度稳定期慢性阻塞性肺疾病(COPD)患者6周、12周的小气道肺功能参数变化。方法:采用随机、单盲、平行对照试验设计,入选42例COPD稳定期患者,分为噻托溴铵干粉剂吸入组(18μg/次,每天1次),异丙托溴铵气雾剂吸入组(40μg/次,qid),总疗程12周。结果:治疗6周末,2组间肺功能无统计学差异,同基线值比较异丙托溴铵组仅最大用力呼气中期流速(FEF25-75)有增高;治疗12周末,噻托溴铵组较异丙托溴铵组FEVl、FEF25、FEF50、FEF25-75均有明显改善,同基线值比较,亦有显著性增加;并且噻托溴铵组用药12周末较6周末患者FEF25增加有显著性意义(P<0.05)。结论:噻托溴铵较异丙托溴铵更能改善轻、中度稳定期COPD患者的肺功能,包括小气道肺功能。
OBJECTIVE: To compare the changes of small airway pulmonary function parameters after 6 weeks and 12 weeks in patients with mild to moderate chronic obstructive pulmonary disease (COPD) with ipratropium bromide aerosol and tiotropium dry powder. Methods: A randomized, single-blind, parallel-controlled trial was designed and 42 stable patients with COPD were enrolled. Patients were divided into tiotropium bromide inhalation group (18μg / time, once daily), ipratropium bromide inhalation Group (40μg / time, qid), the total course of 12 weeks. Results: After 6 weeks of treatment, there was no significant difference in lung function between the two groups. Compared with the baseline value, the maximum forced expiratory flow rate (FEF25-75) in the ipratropium bromide group was increased. After 12 weeks of treatment, the tiotropium group Compared with baseline, the values of FEV1, FEF25, FEF50 and FEF25-75 in ipratropium bromide group were also significantly increased, and the increase of FEF25 in patients treated with tiotropium for 12 weeks was higher than that in 6 weeks Significance (P <0.05). CONCLUSIONS: Tiotropium bromide is more effective than ipratropium bromide in improving lung function in patients with mild to moderate stable COPD, including small airway lung function.