Résumé
Objective To investigate the curative effects of old age severe chronic obstructive pulmonary disease (COPD) patients inhaled Glucocorticoids with the special devices (Turbuhaler).Methods Seventy-six cases of elderly patients with severe acute exacerbation of COPD patients (53 males,23 females) were divided into experimental group(n =38) and control group(n =38),respectively,according to the random number table.In 10 days of therapy,patients of experimental group inhaled budesonide powder of inhalation 0.2 mg twice daily;Control group inhaled oxygen atomization budesonide suspension 1mg twice daily.The changes of panting symptom were observed.Three months followed-up,the test team inhaled budesonide powder of inhalation 1 mg twice daily,control group stopped inhaling drugs,all patients of panting symptom were observed,also were six-minutes walking distance,the frequency of acute exacerbation and adverse reaction.Intent and compliance program data analysis were performed of the experimental data.Results At the end of the stage of therapy,panting symptom of two group patients were all improved (F =8.746,7.952 respectively,P ＜ 0.05) ; Wheezing score between the two groups 1,5,10 days of treatment differences were not statistically significant(P ＞ 0.05).But the incidence rate of adverse reaction in experimental group was significantly lower than that of control group(x2 =11.372,P ＜0.01),and the treatment costs of test team was significantly lower than that of control group(t =4.573,P ＜ 0.01).At the start of the follow-up period (week 0),two groups of acute exacerbation frequency,wheezing,peak expiratory flow and 6 minutes walking distance had no significant difference(P ＞ 0.05).When follow-up period was at tne end of 12 weeks.The test group of patients with acute exacerbation frequency was significantly lower than the control group(aF within grouP =9.343,aF between groups =16.343,the aF interaction =20.017 ; P ＜ 0.05),wheezing in the control group was significantly mitigate (bF within group =8.537,b F between groups =11.453,bF interaction =13.071 ; P ＜ 0.05),and peak expiratory flow rate than the control group improved significantly (cF within group =9.015,cF between groups =12.426,cF interaction =14.852 ;P ＜ 0.05),6 min walking distance increased significantly compared with the control group (d F within group =12.263,d F between groups =21.371,d F interactive =24.651 ; P ＜ 0.05),the differences were statistically significant.Conclusion Elderly patients with moderate to severe COPD inhaled Glucocorticoids,with the special devices(Turbuhaler),not only in acute exacerbation stage the panting symptom was controlled; but also in stable phase the frequency of acute exacerbation was decreased,and the exercise tolerance was improved.Curative effect is obvious withsafety and well-tolerated.
Résumé
Objective To explore the curative effect of inhaled tiotropium upon patients of stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 76 patients (Male/Female =51/25) of stable COPD complicated with pulmonary hypertension were recruited from January 2010 to June 2011.According to table of random digit,they were divided into test group (n =38,M/F =26/12) and control group (n =38,M/F =25/13).Patients of control group inhaled formoterol powder 4.5 μg bid,took oral theophylline sustained-release tablets 0.1 g hid.According to the demand of patient's condition,anti-infective agents and sticky phlegm lyticagent were used.Patients of test group inhaled tiotropium dry powder (18 μg,qd) in addition to the above regimen.All changes in six-minute walk test (SMWT),pulmonary arterial systolic pressure and panting symptom score were recorded at the end of 16 weeks and compared with the baseline.The primary endpoint was the changes in exercise capacity as assessed by SMWT and pulmonary arterial systolic pressure.Safety and tolerance were also investigated.Intent-to-treat and per-protocol analyses were performed.Results After a follow-up period of 16 weeks,both pulmonary arterial systolic pressure and panting symptom score decreased and SMWT walking distance increased (45 ± 16) m in the test group.Compared with the control group,the difference had statistical significance (P ＜ 0.05) and obvious adverse reaction did not occur.Conclusions For patients of stable COPD complicated with pulmonary hypertension,inhaled tiotropium dry powder decreases pulmonary pressure to various extents and improves exercise tolerance and panting symptom.And tolerance is satisfactory.
Résumé
The clinical data of 25 patients with acute exacerbations of chronic obstruction pulmonary disease (AECOPD) admitted from March 2009 to October 2010 were analyzed. The sputum samples were collected and the levels of inflammatory cell, interleukin-8 (IL-8) and eotaxin in sputum were determined. The lung function was measured. Twenty healthy subjects served as controls. The counts of neutrophils and eosinophils, and the levels of IL-8 and eotaxin in sputum of AECOPD were higher than those of health subjects. There was a positive correlation between the levels of IL-8 and the counts of neutrophils (P < 0. 01), and between the levels of eotaxin and the counts of eosinophils in sputum ( P < 0.01). The levels of IL-8 and eotaxin were negatively correlated with the lung function (FEV1% ).