【摘要】 目的探讨支气管舒张剂对不同程度慢性阻塞性肺疾病患者(chronic obstruction pulmonary disease,COPD)患者呼吸困难程度及肺功能变化的影响。方法选取2014年1月~2015年1月铜川市人民医院呼吸科收治的COPD患者50例,根据慢性阻塞性肺疾病诊治指南分为轻度14例、中度18例、重度18例,观察各组患者在吸入噻托溴铵后患者的Borg呼吸困难评分及肺功能指标一秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)、呼气峰流速值(peak expiratory flow,PEF)及深吸气量(inspiratory capacity,IC)的变化情况。结果轻、中、重度组患者在吸入噻托溴铵后FEV1、FVC、PEF及IC均显著改善,且改善率随着COPD患者的病情程度发生显著变化(P<0.05),FEV1、FVC及IC在重度患者治疗前后的改善率最大,PEF在轻度患者治疗前后的改善率最大(P<0.05)。轻、中、重度组患者在吸入噻托溴铵后Borg评分较吸入前均显著提高(P<0.05),吸入后重度COPD患者的Borg评分改善率最高(P<0.05)。COPD患者的FEV1(r=0.372)、FVC(r=0.296)、PEF(r=0.284)及IC值(r=0.704)与患者的Borg评分呈显著的正相关(P<0.05)。结论 COPD患者吸入支气管扩张剂后呼吸困难程度及肺功能显著改善,其中重度COPD患者FEV1、FVC以及IC指标改善率最大,轻度患者PEF指标改善率最大,重度COPD患者呼吸困难程度Borg评分改善率最大。对气流受限的可逆程度的评估,需要对各指标进行综合分析。更多还原

【Abstract】 Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease( COPD) at different degrees. Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People’s Hospital were selected. According to the standard of Global initiative for chronic obstructive lung disease( GOLD),the patients were divided into mild degree of 14 cases,moderate degree of 18 cases and severe degree of 18 case. The changes of Borg score of dyspnea,forced expiratory volume in one second( FEV1),forced vital capacity( FVC),peak expiratory flow( PEF) and inspiratory capacity( IC) after received tiotropium bromide inhalation in each group. Results FEV1,FVC,PEF and IC values significant improved in mild,moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease( P < 0. 05). The improvement rates of FEV1,FVC and IC were highest in patients at severe degree,improvement rate of PEF was highest in patients at mild degree( P <0. 05). After received tiotropium bromide inhalation,the Borg score improved significantly compared with that of pre-treatment in mild,moderate and severe degree groups( P < 0. 05),the improvement rate of Borg score was highest in severe degree group( P < 0. 05). There were significantly positive correlations between Borg score and FEV1( r = 0. 372),FVC( r = 0. 296),PEF( r = 0. 284),IC( r = 0. 704)( all P < 0. 05). Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD,and the improvement rate of FEV1,FVC and IC is highest in patients with COPD at server degree,PEF is highest at mild degree and Borg score is highest at server degree,which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.更多还原