本文選題：肺疾病 + 慢性阻塞性�。� 參考：《中國(guó)全科醫(yī)學(xué)》2015年23期

【摘要】：目的比較不同一氧化碳彌散量(DLCO)和深吸氣量(IC)的COPD患者對(duì)吸入布地奈德福莫特羅治療的反應(yīng)。方法選取2012年6月—2014年6月于滄州市中心醫(yī)院就診的穩(wěn)定期中重度COPD患者105例為研究對(duì)象,患者經(jīng)過(guò)2周的清洗期,均給予3個(gè)月的布地奈德福莫特羅320μg/9μg治療。根據(jù)治療前DLCO占預(yù)計(jì)值百分比和IC占預(yù)計(jì)值百分比,將患者分為DLCO及IC均正常組(A組,10例)、DLCO減低且IC正常組(B組,18例)、DLCO正常且IC減低組(C組,22例)、DLCO及IC均減低組(D組,55例)。收集患者臨床特征資料,采用胸部高分辨率CT進(jìn)行肺氣腫視覺(jué)評(píng)分。比較各組治療前后第1秒用力呼氣末容積(FEV1)、用力肺活量(FVC)及COPD評(píng)估測(cè)試(CAT)評(píng)分的變化。結(jié)果各組男性比例、年齡、吸煙指數(shù)、CAT評(píng)分、急性加重次數(shù)、FVC、FEV1占預(yù)計(jì)值百分比、FVC占預(yù)計(jì)值百分比和肺氣腫視覺(jué)評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),其中,D組CAT評(píng)分高于其他各組;D組急性加重次數(shù)多于A組;C組FVC高于其他各組,D組FVC占預(yù)計(jì)值百分比低于其他各組;D組FEV1占預(yù)計(jì)值百分比低于A組和B組;B組和D組肺氣腫視覺(jué)評(píng)分高于A組和C組(P0.05)。各組治療3個(gè)月后FEV1、FVC及CAT評(píng)分的變化比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);其中,C組FEV1變化的絕對(duì)值和相對(duì)值高于其他各組,D組FEV1變化的相對(duì)值高于B組;C組FVC變化的絕對(duì)值高于其他各組,FVC變化的相對(duì)值高于B組和D組;C組CAT評(píng)分變化大于B組和D組(P0.05)。A組和C組出現(xiàn)咽部不適、聲音嘶啞各1例,D組出現(xiàn)口腔真菌感染1例,經(jīng)治療后均好轉(zhuǎn)。結(jié)論可依據(jù)DLCO聯(lián)合IC對(duì)COPD進(jìn)行分型,DLCO正常且IC減低的患者對(duì)布地奈德福莫特羅的治療反應(yīng)較好。
[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.
【作者單位】： 河北省滄州市中心醫(yī)院呼吸內(nèi)一科;
【分類號(hào)】：R563.9

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