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目的探讨吸入用复方异丙托溴铵溶液对慢性阻塞性肺疾病急性加重期(AECOPD)老年患者血浆脑钠肽(BNP)浓度的影响。方法将我院呼吸内科住院治疗的中重度AECOPD老年患者71例随机分为2组。对照组35例应用吸氧,抗生素抗感染,氨溴索、多索茶碱、糖皮质激素平喘等常规治疗措施;观察组36例在常规治疗基础上加用复方异丙托溴铵溶液2.5m L雾化吸入,bid。观察治疗前及治疗1周后2组患者的肺功能、呼吸困难评分、血浆BNP浓度及左室射血分数(LVEF),并评价临床疗效。结果治疗后观察组临床疗效明显优于对照组(P<0.05),呼吸困难评分和血浆BNP浓度明显低于对照组(P<0.01),而肺功能指标1秒钟用力呼气容积与预计的百分率(FEV1%)和LVEF明显高于对照组(P<0.01)。结论吸入用复方异丙托溴铵溶液雾化吸入可显著改善AECOPD老年患者肺功能,缓解呼吸困难,降低心力衰竭发生的危险性,改善预后,其机制可能与血浆BNP浓度降低有关。
Objective To investigate the effect of inhaled compound ipratropium bromide on plasma brain natriuretic peptide (BNP) in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Seventy-one elderly patients with moderate-severe AECOPD hospitalized for respiratory medicine in our hospital were randomly divided into two groups. In the control group, 35 cases were given conventional therapy including oxygen inhalation, anti-infective antibiotics, ambroxol, doxofylline and glucocorticoid asthma. 36 cases in the observation group were given compound ipratropium bromide solution 2.5 m L Inhalation, bid. The pulmonary function, dyspnea score, plasma BNP concentration and left ventricular ejection fraction (LVEF) were observed before treatment and after 1 week of treatment, and the clinical efficacy was evaluated. Results After treatment, the clinical efficacy of observation group was significantly better than that of control group (P <0.05), dyspnea score and plasma BNP concentration were significantly lower than those of control group (P <0.01), while the forced expiratory volume of lung function index The percentages (FEV1%) and LVEF were significantly higher than those in the control group (P <0.01). Conclusion Inhalation with compound ipratropium bromide inhalation can significantly improve pulmonary function, alleviate respiratory problems, reduce the risk of heart failure and improve prognosis in AECOPD elderly patients. The mechanism may be related to the decrease of plasma BNP concentration.