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目的评价噻托嗅铵对稳定期中、重度慢性阻塞性肺部疾病(COPD)患者肺功能和生存质量的影响。方法 80例中重度COPD稳定期患者分成治疗组(噻托溴铵组)40例和对照组(沙美特罗组)40例,观察两组用药前和治疗3个月、6个月后肺功能、St George’s呼吸问卷(SGRQ)、6min步行试验(6MWT)、BODE指数评分。结果用药3个月和6个月后治疗组FEV1、FEV1/FVC和FEV1占预计值(%)与对照组无显著性差异,而深吸气量(IC)有显著性差异[3个月时(1.76±0.31)vs.(1.49±0.39),P<0.05;6个月时(1.84±0.43)vs.(1.54±0.42),P<0.05]。与对照组比较,SGRQ评分[3个月时(38.2±6.3)vs.(46.3±5.7),P<0.05;6个月时(33.6±5.6)vs.(44.6±6.1),P<0.05]、BODE指数评分[6个月时(3.92±0.56)vs.(4.86±0.61),P<0.05]和6MWT[3个月时(402±51)vs.(341±41),P<0.05;6个月时(469±46)vs.(347±29),P<0.05]改善程度均有显著性差异。结论吸入噻托溴铵能更好的改善稳定期COPD患者IC,提高运动耐力,改善生活质量。
Objective To evaluate the effects of intravenous tiotropium on pulmonary function and quality of life in patients with moderate or severe chronic obstructive pulmonary disease (COPD). Methods Eighty patients with moderate to severe COPD were divided into treatment group (tiotropium bromide group) and control group (salmeterol group), 40 cases. Two groups were observed before treatment and 3 months and 6 months after treatment , St George’s Respiratory Questionnaire (SGRQ), 6min Walk Test (6MWT), BODE index score. Results At 3 and 6 months after treatment, FEV1, FEV1 / FVC and FEV1 in the treatment group had no significant difference from the control group (FEV1, FEV1 / FVC and FEV1), while there was a significant difference in the deep inspiration (IC) (1.76 ± 0.31) vs. (1.49 ± 0.39), P <0.05; at 6 months (1.84 ± 0.43) vs. (1.54 ± 0.42), P <0.05]. Compared with the control group, the SGRQ score [38.2 ± 6.3 vs. 46.3 ± 5.7 at 3 months, P <0.05, 33.6 ± 5.6 vs. 44.6 ± 6 months, P <0.05] , BODE index score (3.92 ± 0.56 vs. 4.86 ± 0.61, P <0.05) and 6MWT at 3 months (402 ± 51 vs. 341 ± 41 months, P <0.05) 6 months (469 ± 46) vs. (347 ± 29), P <0.05] There was a significant difference in improvement. Conclusion Inhalation of tiotropium can improve IC of patients with stable COPD, improve exercise endurance and improve quality of life.