| 摘要: |
| ［摘要］ 目的 观察罗氟司特片联合氟替美维吸入粉雾剂治疗慢性阻塞性肺疾病急性加重（AECOPD）的效果及对血清单核细胞趋化蛋白-1（MCP-1）和白细胞介素-8（IL-8）水平的影响。方法 招募2022年2月至2024年2月商洛市中心医院收治的AECOPD患者200例，采用随机数字表法将其分为观察组（接受罗氟司特片联合氟替美维吸入粉雾剂治疗）和对照组（接受氟替美维吸入粉雾剂治疗），每组100例。两组均连续治疗2个月。比较两组治疗前后血气分析指标、炎症因子和肺功能指标水平，比较两组临床疗效及不良反应发生情况。结果 与治疗前相比，两组治疗后动脉血氧分压（PaO2）、血氧饱和度（SaO2）水平显著升高（P<0.05），动脉血二氧化碳分压（PaCO2）水平显著降低（P<0.05）。相比于对照组，观察组治疗后的PaO2、SaO2水平更高，PaCO2水平更低，差异有统计学意义（P<0.05）。两组治疗后的MCP-1、C反应蛋白（CRP）、IL-8水平均较治疗前显著降低（P<0.05），第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、呼气流量峰值（PEF）水平均较治疗前显著升高（P<0.05），且观察组治疗后MCP-1、CRP、IL-8水平较对照组更低，FEV1、FVC、PEF水平较对照组更高，差异有统计学意义（P<0.05）。观察组临床总有效率显著高于对照组（97.00% vs 88.00%； χ2=5.838，P=0.016）。两组不良反应总发生率比较差异无统计学意义（12.00% vs 13.00%； χ2=0.046，P=0.831）。结论 罗氟司特片联合氟替美维吸入粉雾剂治疗AECOPD的效果显著，安全性好，可有效改善患者血气状况与肺功能，降低炎症因子水平，值得临床推荐。 |
| 关键词: 罗氟司特片 氟替美维吸入粉雾剂 慢性阻塞性肺疾病急性加重 临床疗效 单核细胞趋化蛋白-1 白细胞介素-8 |
| DOI：10.3969/j.issn.1674-3806.2026.05.10 |
| 分类号:R 563 |
| 基金项目:陕西省自然科学基础研究计划项目（编号：2023-JC-QN-0139） |
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| Observation on the clinical efficacy of roflumilast tablets combined with fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease and its effects on serum MCP-1 and IL-8 levels |
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WANG Qinqin1, LI Kai1, ZHANG Sanhong2
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1.Department of Pharmacy, Shangluo Central Hospital, Shangluo 726000, China; 2.Ward 1, Department of Respiratory and Critical Care Medicine, Baoji Third Hospital, Baoji 721004, China
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| Abstract: |
| ［Abstract］ Objective To observe the clinical efficacy of roflumilast tablets combined with fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and its effects on serum monocyte chemoattractant protein-1(MCP-1) and interleukin-8(IL-8) levels. Methods A total of 200 patients with AECOPD who were admitted to Shangluo Central Hospital from February 2022 to February 2024 were recruited and randomly divided into observation group(receiving the treatment of roflumilast tablets combined with fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation) and control group(receiving fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation) by using random number table method, with 100 patients in each group. Both groups were treated continuously for 2 months. The levels of blood gas analysis indicators, inflammatory factors and pulmonary function indicators were compared between the two groups before and after the treatment. The clinical efficacy and the incidence of adverse reactions were compared between the two groups. Results Compared with those before the treatment, the levels of partial pressure of arterial oxygen(PaO2) and oxygen saturation(SaO2) in the two groups significantly increased after the treatment(P<0.05), while the levels of partial pressure of arterial carbon dioxide(PaCO2) in both groups significantly decreased after the treatment(P<0.05). Compared with those in the control group, the levels of PaO2 and SaO2 were higher, while the levels of PaCO2 were lower in the observation group after the treatment, and the differences were statistically significant(P<0.05). The levels of MCP-1, C-reactive protein(CRP) and IL-8 in the two groups after the treatment were significantly lower than those before the treatment(P<0.05), and the levels of forced expiratory volume in 1 second(FEV1), forced vital capacity(FVC), and peak expiratory flow(PEF) in the two groups after the treatment were significantly higher than those before the treatment(P<0.05). Moreover, the levels of MCP-1, CRP and IL-8 in the observation group were lower than those in the control group after the treatment, while the levels of FEV1, FVC and PEF in the observation group were higher than those in the control group after the treatment, and the differences were statistically significant(P<0.05). The total clinical effective rate of the observation group was significantly higher than that of the control group(97.00% vs 88.00%; χ2=5.838, P=0.016). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(12.00% vs 13.00%; χ2=0.046, P=0.831). Conclusion Roflumilast tablets combined with fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation are significantly effective and safe in treatment of AECOPD. The combined treatment can effectively improve the blood gas condition and lung function of the patients and reduce their inflammatory factor levels, and is worthy of clinical recommendation. |
| Key words: Roflumilast tablets Fluticasone furoate, umeclidinium bromide and vilanterol trifenatate powder for inhalation Acute exacerbation of chronic obstructive pulmonary disease(AECOPD) Clinical efficacy Monocyte chemoattractant protein-1(MCP-1) Interleukin-8(IL-8) |
