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1. 重庆医科大学附属第二医院呼吸内科,重庆,400010
2. 重庆市璧山县人民医院呼吸内科,重庆,402760
纸质出版日期:2014,
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唐万艳, 冉雪梅, 蒋幼凡. 氟替卡松/沙美特罗、噻托溴铵对中重度慢性阻塞性肺疾病患者动脉弹性功能的影响[J]. 重庆医科大学学报, 2014,38(9):1245-1250.
Tang Wanyan, Ran Xuemei, Jiang Youfan. Effects of fluticasone propionate/salmeterol and tiotropium on arterial elastic function of patients with moderate to severe chronic obstruction pulmonary disease[J]. Journal of Chongqing Medical University, 2014,38(9):1245-1250.
唐万艳, 冉雪梅, 蒋幼凡. 氟替卡松/沙美特罗、噻托溴铵对中重度慢性阻塞性肺疾病患者动脉弹性功能的影响[J]. 重庆医科大学学报, 2014,38(9):1245-1250. DOI:
Tang Wanyan, Ran Xuemei, Jiang Youfan. Effects of fluticasone propionate/salmeterol and tiotropium on arterial elastic function of patients with moderate to severe chronic obstruction pulmonary disease[J]. Journal of Chongqing Medical University, 2014,38(9):1245-1250. DOI:
目的:观察沙美特罗/氟替卡松(舒利迭)(fluticasone propionate/salmeterol,FSC)、噻托溴铵(tiotropium)对稳定期中重度慢性阻塞性肺疾病(chronic obstruction pulmonary disease,COPD)患者动脉弹性功能的影响。方法:将入选的136例COPD患者随机分为F组(45例)、T组(45例)、B组(46例)。B组患者仅予常规治疗,F组及T组在此基础上分别加用舒利迭、噻托溴铵。12周后观察各组臂踝脉搏波传导速度(brachial-angle pulse wave velocity,baPWV)、桡动脉增强指数(augmentation index,AI)、大小动脉顺应性、超敏C反应蛋白的变化。结果:①多元逐步回归分析发现,在研究因素中,病程(P=0.000)、超敏C反应蛋白(P=0.000)、体质指数(P=0.000)、吸烟指数(P=0.002)与baPWV正相关,第一秒用力呼气容积与baPWV负相关(P=0.000);②12周后,F组、T组的大小动脉顺应性、超敏C反应蛋白均有改善,组内比较差异均有统计学意义(P<0.01);且F组改善更明显(P<0.05)。治疗后,F组、T组分别与B组比较,均有统计学差异(P<0.05)。B组患者的动脉弹性指标及F组、T组的AI均未见明显改善(P >0.05)。③F组、T组baPWV均随着时间下降且F组下降更明显,F组基线处baPWV越大,其下降越明显。B组baPWV未见明显下降趋势。结论:和噻托溴铵相比,舒利迭能显著改善COPD患者的动脉弹性。
Objective:To explore the effects of fluticasone propionate/salmsalmeterol(FSC)and tiotropium on arterial stiffness in pa-tients with stable chronic obstruction pulmonary disease(COPD). Methods:All 136 patients with stable COPD were randomly divided into three groups:FSC group(group F,n=45),tiotropium group(group T,n=45) and blank control group(group B,n=46). Patients in group B received the conventional therapy while those in group F FSC per day for 12 weeks and those in group T inhaled tiotropium per day for 12 weeks. Changes in brachial-angle pulse wave velocity(baPWV),large and small arterial compliance(C1 and C2),augementation index(AI),high sensitive C-reactive protein(hsCRP) were observed. Results:①Multiple stepwise regression analysis demonstrated that body mass index(P=0.000),course of disease(P=0.000),hsCRP(P=0.000) and smoking index(P=0.002) were pos-itively associated with baPWV while the forced expiratory volumein one second(FEV1)(P=0.000) was negatively associated with baPWV. ②At 12 weeks after the treatment,hsCRP and C1,C2 were improved compared with those before the treatment(P<0.01),more obviously in group F(P<0.05). Significant differences presented in the above indexes in comparison between group F,group T and group B after the treatment(P<0.05). The arterial elastic paramenters of group B and AI of group F and group T were not sig-nificantly improved(P >0.05). ③baPWV of group F and group T was decreased along with the time,more obvious in group F and most significantly in group c(baPWV>21.21 m/s) among subgroups of group F. No decrease of baPWV was observed in group B. Conclusion:Fluticasone propionate/salmsalmeterol had broader impacts on arterial stiffness of patients with COPD compared with tiotropium.
氟替卡松/沙美特罗噻托溴铵慢性阻塞性肺疾病动脉弹性功能
fluticasone propionate/salmeteroltiotropiumchronic obstruction pulmonary diseasearterial elastic function
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