覃建民++唐艳媚++计贞++卢剑��

【摘要】目的探讨噻托溴铵治疗慢性阻塞性肺疾病（COPD）患者的临床疗效及安全性。

方法将94例COPD患者随机分为观察组48例和对照组46例，对照组给予常规治疗，观察组给予常规治疗加用噻托溴铵吸入治疗，观察两组患者肺功能变化及用药过程的不良反应，并评价临床疗效。

结果经治疗4周后、8周后，观察组的临床疗效均明显优于对照组（P<0.01）。治疗前两组患者第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC比较差异均无统计学意义（P>0.05）。与治疗前相比较，观察组经治疗4周后、8周后FEV1、FVC、FEV1/FVC均逐步升高（P<0.01），对照组经治疗4周后、8周后FVC、FEV1/FVC均逐步升高（P<0.05或0.01）。治疗4周后、8周后观察组的FEV1、FVC、FEV1/FVC均高于对照组（P<0.01）。用药期间两组均未发生明显不良反应。

结论噻托溴铵能明显改善COPD患者肺功能、提高治疗效果，且无明显不良反应。

【关键词】噻托溴铵；慢性阻塞性肺疾病；临床疗效；安全性

中图分类号：R563文献标识码：ADOI：10.3969/j.issn.10031383.2017.01.014

Clinical efficacy and safety of tiotropium bromide for patients with chronic obstructive pulmonary disease

[HJ2][HJ]

QIN Jianmin，TANG Yanmei，JI Zhen，LU Jian

（The First Peoples Hospital of Hechi，Hechi 546300，China）

[HJ2][HJ]

【Abstract】ObjectiveTo explore clinical efficacy and safety of tiotropium bromide for patients with chronic obstructive pulmonary disease（COPD）.

MethodsA total of 94 patients with COPD were randomly divided into observation group（n=48） and control group（n=46）.The control group were treated with conventional therapy，and the observation group were treated by conventional therapy combined with tiotropium bromide.The changes of pulmonary function and adverse reactions of the two groups were observed，and the clinical effects were evaluated.

ResultsAfter 4 weeks and 8 weeks of treatment，the clinical effect in the observation group was significantly better than that in the control group（P<0.01）.Difference of forced expiatory volume in the first second（FEV1），forced vital capacity（FVC） and FEV1/FVC of the two groups was not statistically significant（P>0.05）.Compared with those before treatment，FEV1， FVC and FEV1/FVC of the observation group increased gradually （P<0.01），so did FVC and FEV1/FVC of the control group（P<0.05 or 0.01）.In addition，after 4 weeks and 8 weeks of treatment，FEV1，FVC and FEV1/FVC of the observation group were all significantly higher than those of the control group（P<0.01）.There were no obvious adverse reactions in the two groups during treatment.

ConclusionTiotropium bromide can obviously improve pulmonary function and raise the clinical effects for patients with COPD，it has no severe adverse reactions.

【Key words】tiotropium bromide；COPD；clinical effect；safety

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是以氣流受限不完全可逆为特点的临床常见呼吸系统疾病，COPD发病率较高，以老年人多见，患者肺功能往往呈现渐进性下降，严重影响患者生活质量，甚至可危及生命[1]。抗胆碱药物在COPD患者的治疗中越来越受到关注，以往的抗胆碱能药物半衰期较短，需多次给药，而噻托溴铵是一种新型长效吸入性抗胆碱能药物，选择性持久作用于支气管M型受体，从而持续有效地改善患者呼吸困难症状[2]。笔者就噻托溴铵治疗COPD患者的临床疗效及安全性进行分析，报告如下。