标题：噻托溴铵治疗COPD稳定期患者的疗效及其对血清MMP-9和 IL-8的影响

      作者：谢骞，杨春，张银莉
    (重庆市九龙坡区第二人民医院内二科，重庆 400052)

      卷次： 2016年27卷1期

      【摘要】 目的 观察噻托溴铵治疗慢性阻塞性肺疾病(COPD)稳定期患者的临床疗效，并探讨其对血清基质
金属蛋白酶 9 (MMP-9)和白细胞介素-8 (IL-8)水平的影响。方法 选择本院 2014年 1月至 2015年 3月收治的
COPD稳定期患者136例，随机分为对照组和观察组各68例。对照组进行常规治疗，观察组在对照组治疗的基础上
应用噻托溴铵吸入治疗，1次/d，2个月为一个疗程。评估两组患者治疗前后的最大呼气流量(PEF)、一秒钟用力呼
气量预计值(FEV1%)、最大肺活量(FVC)等肺功能指标；应用呼吸困难指数(mMRC)评估患者呼吸状况；检测血清中
基质金属蛋白酶9 (MMP-9)和白细胞介素-8 (IL-8)浓度。结果 观察组治疗后的PEF、FEV1%和FVC结果分别为
(2.60±0.49) L、(64.68±1.57)%和(1.86±0.60) L，对照组为(2.04±0.51) L、(60.44±1.30)%和(1.75±0.51) L，观察组高于对
照组，且两组治疗后均高于治疗前，差异均有统计学意义(P<0.05)；观察组治疗后的mMRC评分为(1.80±0.22)分，对
照组治疗后为(1.98±0.29)分，观察组低于对照组，且两组治疗后mMRC评分均低于治疗前，差异均有统计学意义
(P＜0.05)；观察组治疗后的MMP-9和 IL-8分别为(398.75±57.46) μg/L和(7.12±1.16) μg/L，均低于对照组治疗后的
(529.64±61.23) μg/L和(9.83±1.05) μg/L，且两组 IL-8和MMP-9治疗后均低于治疗前，差异均有统计学意义(P<0.05)；
观察组的总有效率为 97.06%，明显高于对照组的 88.24%，差异有统计学意义(P<0.05)。结论 噻托溴铵对COPD
稳定期患者具有较好的临床疗效，能够显著改善肺功能，降低MMP-9和 IL-8水平，对稳定肺功能具有显著作用。

      【关键词】 噻托溴铵；慢性阻塞性肺疾病；疗效；基质金属蛋白酶9；白细胞介素-8

      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2016）01—0034—03


Clinical effect of tiotropium bromide in patients with chronic obstructive pulmonary disease at stable stage and
its effects on serum MMP-9 and IL-8.
XIE Qian, YANG Chun, ZHANG Yin-li. The Second Department of Internal
Medicine, the Second People's Hospital of Jiulongpo District of Chongqing, Chongqing 400052, CHINA

【Abstract】 Objective To observe the clinical effect of tiotropium bromide in patients with chronic obstructive
pulmonary disease (COPD) at stable stage, and to explore its effect on serum matrix metalloproteinase-9 (MMP-9) and
interleukin-8 (IL-8). Methods A total of 136 COPD patients at stable stage were selected in the hospital from January
2014 to March 2015, which were randomly divided into the control group and the observation group, with 68 cases in
each group. The control group was given conventional treatment, and the observation group received treatment of tiotropium
bromide inhalation based on the control group, 1 time/d, for 2 months as a treatment course. Pulmonary function indexes
before and after treatment, including peak expiratory flow (PEF), forced expiratory volume in one second the expected
value (FEV1%) and forced vital capacity (FVC), were evaluated. Dyspnea index (mMRC) was applied to assess the re-
·论 著·
6350.2016.01.011