Effects of salmeterol fluticasone plus tiotropium bromide on right cardiac and thyroid functions of ;patients of chronic obstructive pulmonary disease with chronic cor pulmonale / 中华全科医师杂志

ABSTRACT

Objective To explore the influence of salmeterol fluticasone plus tiotropium bromide on right cardiac and thyroid functions of patients of chronic obstructive pulmonary disease ( COPD) with chronic cor pulmonale .Methods A total of 92 cases of COPD patients with chronic cor pulmonale at our hospital from July to December 2012 were recruited as subjects and divided randomly into 2 groups of treatment ( n=47) and control (n=45).The control group received diuretics and vasodilative drugs while the treatment group had additional therapies of salmeterol fluticasone ( 50/500 μg ) twice daily plus tiotropium bromide once per day once daily for 6 months.Measure and compare two groups of patients′FEV1%, forced expiratory volume in one second(FEV1), status of vigor, brain natriuretic peptide(BNP), left ventricular ejection fraction ( LVEF ) , ultrasonic cardiogram ( right ventricular outflow tract , right ventricular internal diameter, right pulmonary artery trunk ) and value of thyroid function before and after treatment .Results Before treatment, the treatment group′s FEV1 (%) (36 ±10)%, FEV1 (1 036 ±410) ml, BNP (357 ± 101) ng/L, LVEF (46.2 ±10.4)%, internal diameter of right ventricular outflow tract (36.0 ±5.4) mm, right ventricular internal diameter (38.1 ±6.7) mm, right pulmonary artery trunk (24.0 ±3.6) mm, TT3 (1.47 ±0.38) nmol/L, TT4 (114.56 ±21.39) nmol/L, FT3 (4.47 ±1.42) pmol/L, FT4 (15.6 ± 2.5) pmol/L and TSH (2.50 ±0.91) mU/L showed no marked difference from those of control group (P>0.05).After treatment, the treatment group′s FEV1(%)(58 ±1)%, FEV1(1 706 ±456)ml, BNP(225 ± 52) ng/L, LVEF (57.1 ±11.5)%, internal diameter of right ventricular outflow tract (30.1 ±4.2) mm, right ventricular internal diameter ( 32.0 ±3.9 ) mm and right pulmonary artery trunk ( 20.2 ±2.3 ) mm greatly improved ( P 0.05 ) .However , no obvious difference existed in the control group′s BNP, LVEF, internal diameter of right ventricular outflow tract , right ventricular internal diameter , right pulmonary artery trunk and value of thyroid function before and after treatment ( P >0.05 ) . Conclusion Salmeterol fluticasone plus tiotropium bromide can effectively improve right cardiac functions of patients of COPD with chronic cor pulmonale , without marked suppression of thyroid function .