| 姜蓉,周迎春,陈燕.布地奈德/福莫特罗治疗老年AECOPD的疗效及对气道重塑和炎症的影响.[J].中南医学科学杂志.,2025,(6):1129-1132. |
| 布地奈德/福莫特罗治疗老年AECOPD的疗效及对气道重塑和炎症的影响 |
| The efficacy of budesonide/formoterol in treating elderly patients with AECOPD and the influence on airway remodeling and inflammation |
| 投稿时间：2024-04-24 修订日期：2024-12-20 |
| DOI：10.15972/j.cnki.43-1509/r.2025.06.047 |
| 中文关键词: 布地奈德/福莫特罗 COPD急性加重期 气道重塑 炎症反应 |
| 英文关键词:budesonide/formoterol inhalant acute exacerbation of COPD airway remodeling inflammatory response |
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| 中文摘要: |
| 目的探讨布地奈德/福莫特罗雾化吸入治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)的效果及对气道重塑、炎症反应的影响。 方法将90例老年AECOPD患者随机分为对照组和观察组,每组45例。对照组给予异丙托溴铵雾化吸入治疗,观察组在对照组基础上给予布地奈德/福莫特罗粉吸入剂治疗,比较两组治疗前及治疗8周后的肺功能指标[第1秒用力呼气容积(FEV1)、FEV1占用力肺活量百分比(FEV1/FVC)、75%肺活量最大呼气流量(FEF75%)]、呼吸力学指标[内源性呼气末正压(PEEPi)、气道阻力(R)、静态肺顺应性(Cst)]、血清炎症因子[白细胞介素-18(IL-18)、淀粉样蛋白A(SAA)、白三烯B4(LTB4)]及气道重塑指标[基质金属蛋白酶-2(MMP-2)、金属蛋白酶组织抑制剂-1(TIMP-1)、转化生长因子-β1(TGF-β1)]。 结果治疗8周后,观察组与对照组FEV1、FEV1/FVC、FEF75%水平均高于治疗前(P＜0.05),且观察组高于对照组(P＜0.05)；两组PEEPi、R值均低于治疗前(P＜0.05),且观察组低于对照组(P＜0.05)；Cst值高于治疗前(P＜0.05),且观察组高于对照组(P＜0.05)；两组血清IL-8、SAA、LTB-4、MMP-2、TIMP-1、TGF-β1水平均低于治疗前(P＜0.05),且观察组低于对照组(P＜0.05)。 结论应用布地奈德/福莫特罗雾化吸入治疗老年AECOPD患者能提高其肺功能,改善其呼吸通气状况,有效抑制血清炎症反应,通过下调血清MMP-2、TIMP-1、TGF-β1水平以改善气道重塑。 |
| 英文摘要: |
| AimTo investigate the effects of budesonide/formoterol aerosol inhalation on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the elderly and the influence on airway remodeling and inflammatory response. MethodsTotally 90 elderly patients with AECOPD were randomly divided into a control group and an observation group, with 45 cases in each group. The control group was treated with ipratropium bromide aerosol inhalation, while the observation group was given budesonide/formoterol powder for inhalation based on the control group. The changes of pulmonary function indexes [forced expiratory volume in the first second (FEV1), percentage of FEV1 to forced vital capacity (FEV1/FVC), maximum expiratory flow at 75% vital capacity (FEF75%)], respiratory mechanics indexes [intrinsic positive end-expiratory pressure (PEEPi), airway resistance (R), static lung compliance (Cst)], serum inflammatory factors [interleukin-18 (IL-18), serum amyloid A (SAA), leukotriene B4 (LTB4)] and airway remodeling indexes [matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-1), transforming growth factor-β1 (TGF-β1)] were compared between the two groups before treatment and after 8 weeks of treatment. ResultsAfter 8 weeks of treatment, the levels of FEV1, FEV1/FVC, and FEF75% in both the observation group and the control group were higher than those before treatment (P＜0.05), with the observation group showing higher values than the control group (P＜0.05). The PEEPi and R values in both groups were lower than those before treatment (P＜0.05), with the observation group exhibiting lower values than the control group (P＜0.05). The Cst value was higher than the level before treatment (P＜0.05), and the observation group had a higher value than the control group (P＜0.05). The serum levels of IL-8, SAA, LTB-4, MMP-2, TIMP-1, and TGF-β1 in both groups were lower than those before treatment (P＜0.05), and the observation group showed lower levels than the control group (P＜0.05). ConclusionThe application of budesonide/formoterol aerosol inhalation in elderly patients with AECOPD can significantly enhance the pulmonary function, improve the respiratory ventilation status, effectively inhibit serum inflammatory response, and may improve airway remodeling by down-regulating serum MMP-2, TIMP-1 and TGF-β1 levels. |
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