2024 年第 1 期 第 19 卷

双长效支气管扩张剂治疗支气管扩张症合并慢性阻塞性肺疾病的临床效果及肺功能改善效果研究

Clinical efficacy and pulmonary function improvement of double long-acting bronchodilator in the treatment of bronchiectasis complicated with chronic obstructive pulmonary disease

作者：崔立静 张树倩 王亮 孟静

英文作者：Cui Lijing Zhang Shuqian Wang Liang Meng Jing

单位：河北省胸科医院呼吸科，石家庄050041

英文单位：Department of Respiratory Hebei Chest Hospital Shijiazhuang 050041 China

关键词：支气管扩张症；慢性阻塞性肺疾病；双长效支气管扩张剂；肺功能

英文关键词：Bronchiectasis;Chronicobstructivepulmonarydisease;Doublelong-actingbronchodilator;Pulmonaryfunction

• 摘要：

• 目的  分析双长效支气管扩张剂治疗支气管扩张症合并慢性阻塞性肺疾病（COPD）的临床效果及肺功能改善效果。方法  通过盲法、便利抽样、对照原则回顾性研究河北省胸科医院呼吸三科2019年9月至2021年9月接诊的100例支气管扩张症合并COPD患者，根据治疗方法的不同分为观察组和对照组，每组50例。对照组给予噻托溴铵吸入粉雾剂治疗，观察组给予噻托溴铵奥达特罗吸入喷雾剂治疗，治疗6个月。比较2组临床疗效、肺功能、圣乔治呼吸问卷（SGRQ）评分、改良呼吸困难指数（mMRC）评分、动脉血气指标、不良反应总发生率和1年再入院率。结果  观察组总有效率高于对照组［96.0%(48/50)比78.0%(39/50)］(P=0.007)。观察组治疗2、4、6个月后用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、FEV1/FVC均高于对照组，SGRQ评分、mMRC评分均低于对照组，动脉血二氧化碳分压低于对照组，动脉血氧分压高于对照组（均P＜0.05）。2组不良反应总发生率比较差异无统计学意义（P=1.000）。观察组1年再入院率低于对照组［2.0%(1/50)比16.0%(8/50)］(P=0.036)。结论  双长效支气管扩张剂噻托溴铵奥达特罗吸入喷雾剂在改善支气管扩张症合并COPD患者肺功能以及动脉血氧状态方面效果显著，可有效缓解患者呼吸困难等症状，降低再入院率，且安全性较好。

• Objective  To analyze the clinical efficacy and pulmonary function improvement effect of double long-acting bronchodilator in the treatment of bronchiectasis complicated with chronic obstructive pulmonary disease (COPD). Methods  A total of 100 patients with bronchiectasis complicated with COPD admitted to the Third Department of Respiratory Medicine, Hebei Chest Hospital from September 2019 to September 2021 were retrospectively studied by blind method, convenient sampling and control principle. According to different treatment methods, they were divided into observation group and control group, with 50 cases in each group. The control group was treated with tiotropium bromide inhalation powder spray, and the observation group was treated with tiotropium odaterol soft mist inhaler, all for 6 months. The clinical efficacy, pulmonary function, St. George′s Respiratory Questionnaire (SGRQ) score, modified medical research council dyspnea index (mMRC) score, arterial blood gas index, total incidence of adverse reactions and 1-year readmission rate were compared between the two groups. Results  The total effective rate of observation group was higher than that of control group［96.0%(48/50) vs 78.0%(39/50)］(P=0.007). After 2, 4, and 6 months of treatment, the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and FEV1/FVC of observation group were higher than those of control group, the SGRQ score and mMRC score of observation group were lower than those of control group, the partial pressure of carbon dioxide of observation group was lower than that of control group, and the partial pressure of oxygen of observation group was higher than that of control group (all P＜0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P=1.000). The 1-year readmission rate of observation group was lower than that of control group［2.0%(1/50) vs 16.0%(8/50)］(P=0.036). Conclusions  The double long-acting bronchodilator tiotropium odaterol soft mist inhaler has a significant effect on improving pulmonary function and arterial blood oxygen status in patients with bronchiectasis complicated with COPD, which can effectively relieve the symptoms of dyspnea and reduce the readmission rate, and has certain safety.