吸入糖皮质激素治疗稳定期COPD的疗效及对患者内皮功能及生活质量的影响

摘要

目的:探究吸入糖皮质激素( ICS)对慢性阻塞性肺疾病( COPD)患者一氧化氮( NO)、肺功能、内皮功能、生活质量影响临床疗效. 方法:将2014年1月至2015年1月期间因稳定期COPD住院治疗患者中NO呼出量水平较高者40例纳入本研究,并将其随机均衡分为研究组和对照组,每组为20例. 对照组患者采用常规抗炎等治疗,研究组患者在对照组基础上加上吸入糖皮质激素治疗. 对比两组治疗前后肺功能,第1s用力呼气容积( FEV1)、第1s用力呼气容积/用力肺活量( FEV1/FVC)、最大呼气流量( PEF)、呼出气NO水平、内皮功能、生活质量( CAT评分)变化情况. 结果:两组治疗后肺功能存在一定程度改善,且研究组FEV1、FEV1/FVC、PEF改善均明显优于对照组患者,差异具有统计学意义( P<0.05);治疗后,对照组IMT、VS、VD、RI和血清ET-1、sIcam-1较治疗前无明显差异( P>0.05) ,而研究组IMT、RI和血清ET-1、sIcam-1较治疗前降低,VS、VD较治疗前升高,差异具有统计学意义(P<0.05);治疗后,对照组血清呼出气NO和生活质量评分较治疗前无明显差异(P>0.05),而研究组呼出气NO、生活质量评分较治疗前降低,差异具有统计学意义( P<0.05). 结论:吸入糖皮质激素可以显著改善稳定期COPD患者肺功能,降低呼出气NO水平,提升内皮功能,生活质量也随之改善.%Objective:To explore the clinical effect of inhaled corticosteroid ( ICS ) on the nitric oxide ( NO ) , pulmonary function and quality of life in patients with chronic obstructive pulmonary disease ( COPD) . Method:From January 2014 to January 2015, 40 cases hospitalized for COPD with high NO ex-haled volume were selected and divided into study group and control group, 20 cases in each group. The con-trol group was treated with routine treatment, while the study group was treated with inhaled glucocorticoid on the basis of routine treatment. After a week of treatment, the pulmonary function of the patients, second forced expiratory volume (FEV1), forced expiratory volume in 1 second (FEV1/FVC), Endothelial func-tion were observed. Result:The pulmonary function of the two groups was improved, and the improvement of FEV1/FVC and FEV1 in the study group were significantly better than those in the control group, and the difference was statistically significant ( P<0.05);After treatment, IMT, VS, VD, RI, and serum ET-1, sI-cam 1 of the control group had no obvious difference compared with those before treatment (P > 0.05), while IMT, RI and serum ET - 1, sI-cam 1 in the study group reduced, VS, VD was higher than before treatment, the difference was statistically significant (P < 0.05); After treatment, the exhaled serum NO breath and quality of life scores in the control group had no obvious difference compared with those before treatment ( P>0.05) , while breath NO, quality of life scores in the study group reduced, the difference was statistically significant (P< 0.05).Conclusion: Inhaled corticosteroids can improve the pulmonary function of patients with COPD, reduce the NO level of exhaled breath, improve the endothelial function and the quality of life.