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[摘要] 目的 探討噻托溴銨联合舒利迭对慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）患者动脉血气参数的影响。 方法 选择2015年3月～2016年8月我院收治的COPD患者60例，根据随机数字表法分为两组，各30例。对照组予舒利迭治疗，观察组予噻托溴铵联合舒利迭治疗。比较两组肺功能和动脉血气各项指标、呼吸困难情况以及用药安全性。 结果 治疗后，观察组第1秒用力呼气量占预计值百分比（volume in one second as percentage of predicted volume，FEV1%Pre）、用力肺活量（forced vital capacity，FVC）、第1秒用力呼气容积（forced expiratory volume in one second，FEV1）水平均显著高于对照组，差异有统计学意义（P<0.05）。观察组动脉血二氧化碳分压（partial pressure of carbondioxide，PaCO2）水平显著低于对照组，动脉血氧分压（partial pressure of oxygen，PaO2）水平较对照组明显提高，差异有统计学意义（P<0.05）。两组治疗后呼吸困难评分较治疗前均改善显著，观察组低于对照组，差异有统计学意义（P<0.05）。观察组不良反应发生率为10.00%（3/30），对照组中不良反应发生率为3.33%（1/30），组间比较差异无统计学意义（P>0.05）。 结论 对COPD患者实施噻托溴铵联合舒利迭治疗疗效显著，能有效改善患者肺功能、动脉血气及呼吸状况，且不会增加毒副作用，安全性较高。
[关键词] 噻托溴铵；舒利迭；慢性阻塞性肺疾病；动脉血气
[中图分类号] R563.9 [文献标识码] B [文章编号] 1673-9701（2017）08-0116-03
[Abstract] Objective To investigate the effect of tiotropium bromide combined with seretide on arterial blood gas parameters in patients with chronic obstructive pulmonary disease（COPD）. Methods 60 patients with COPD admitted in our hospital from March 2015 to August 2016 were chosen and divided into two groups according to the random number table method， with 30 cases in each group. The control group was treated with seretide， and the observation group was treated with tiotropium bromide combined with seretide. Pulmonary function，the indicators of arterial blood gas，breathing difficulties and drug safety between the two groups were compared. Results After treatment， the levels of volume in one second as percentage of predicted volume（FEV1% Pre）， forced vital capacity（FVC），forced expiratory volume in one second（FEV1） were higher than those of control group， and the difference was significant（P<0.05）. The level of partial pressure of arterial blood carbon dioxide（PaCO2） in the observation group was significantly lower than that in the control group. The level of arterial oxygen partial pressure（PaO2） in the observation group was significantly higher than that in the control group，and the difference was significant（P<0.05）. Dyspnea scores in the two groups after treatment improved significantly than before treatment.And the dyspnea score in the observation was lower than that of the control group，and the difference was significant（P<0.05）. The incidence of adverse reactions was 10.00%（3/30） in the observation group， and the adverse reactions rate in the control group was 3.33%（1/30）， there was no significant difference between the two groups（P>0.05）. Conclusion The efficacy of tiotropium bromide combined with seretide applied in COPD patients is significant， which can improve the pulmonary function of patients， arterial blood gas and respiratory status and cannot increase the toxic side effects， with higher safety.
[关键词] 噻托溴铵；舒利迭；慢性阻塞性肺疾病；动脉血气
[中图分类号] R563.9 [文献标识码] B [文章编号] 1673-9701（2017）08-0116-03
[Abstract] Objective To investigate the effect of tiotropium bromide combined with seretide on arterial blood gas parameters in patients with chronic obstructive pulmonary disease（COPD）. Methods 60 patients with COPD admitted in our hospital from March 2015 to August 2016 were chosen and divided into two groups according to the random number table method， with 30 cases in each group. The control group was treated with seretide， and the observation group was treated with tiotropium bromide combined with seretide. Pulmonary function，the indicators of arterial blood gas，breathing difficulties and drug safety between the two groups were compared. Results After treatment， the levels of volume in one second as percentage of predicted volume（FEV1% Pre）， forced vital capacity（FVC），forced expiratory volume in one second（FEV1） were higher than those of control group， and the difference was significant（P<0.05）. The level of partial pressure of arterial blood carbon dioxide（PaCO2） in the observation group was significantly lower than that in the control group. The level of arterial oxygen partial pressure（PaO2） in the observation group was significantly higher than that in the control group，and the difference was significant（P<0.05）. Dyspnea scores in the two groups after treatment improved significantly than before treatment.And the dyspnea score in the observation was lower than that of the control group，and the difference was significant（P<0.05）. The incidence of adverse reactions was 10.00%（3/30） in the observation group， and the adverse reactions rate in the control group was 3.33%（1/30）， there was no significant difference between the two groups（P>0.05）. Conclusion The efficacy of tiotropium bromide combined with seretide applied in COPD patients is significant， which can improve the pulmonary function of patients， arterial blood gas and respiratory status and cannot increase the toxic side effects， with higher safety.