>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
COPD稳定期患者噻托溴铵联合沙美特罗/ 氟替卡松治疗效果的CAT量表评估
作者:姜艳平1  程改存2  赵云峰1  杨远1 
单位:1. 东南大学附属中大医院 呼吸科, 江苏 南京 210009;
2. 南京市浦口医院 内科, 江苏 南京 210031
关键词:噻托溴铵 沙美特罗/氟替卡松 慢性阻塞性肺疾病 慢性阻塞性肺疾病评估测试量表 健康相关生活质量 
分类号:R563
出版年·卷·期(页码):2012·31·第三期(294-298)
摘要:

目的:探讨噻托溴铵联合沙美特罗/氟替卡松吸入治疗的慢性阻塞性肺疾病(COPD)稳定期患者采用观察健康相关生活质量改善情况的COPD评估测试量表(CAT)评估的意义。方法:选择重度、极重度COPD稳定期患者125例,根据患者治疗方式分为噻托溴铵联合沙美特罗/氟替卡松吸入治疗组(观察组,78例)和沙美特罗/氟替卡松吸入治疗组(对照组,47例),入组时登记临床基本资料,在入组时、3个月末、6个月末分别行肺功能检查和CAT量表评分,记录6个月中患者出现急性加重的次数。结果:入组时观察组和对照组患者各项临床指标均无显著差异。在3个月末和6个月末时,两组患者CAT评分比入组时均显著降低(均P<0.05),第1秒用力呼气容积占预计值百分比(FEV1%)较入组时均显著升高(均P<0.05),且观察组患者CAT评分较对照组低(P<0.05),FEV1%较对照组高(P<0.05)。患者CAT评分与FEV1%之间中度负相关(Pearson相关系数波动于-0.58~-0.79)。在随访过程中,出现急性加重患者CAT评分比未出现急性加重患者高(P<0.05)。结论:与单一使用沙美特罗/氟替卡松治疗相比,噻托溴铵联合沙美特罗/氟替卡松吸入治疗可以更加显著地降低COPD稳定期患者的CAT评分,提高患者健康相关生活质量,改善肺功能,减少急性加重;CAT量表可以作为COPD稳定期患者噻托溴铵联合沙美特罗/氟替卡松吸入治疗前后健康相关生活质量评价的一个有效工具。

Objective: To investigate the improvement of health-related quality of life during stable stage of chronic obstructive pulmonary disease(COPD) with salmeterol/fluticasone therapy using COPD assessment test(CAT). Methods: 125 subjects with moderate-to-severe COPD treated with a combination of tiotropium bromide and salmeterol/fluticasone(observed group, n=78), or Salmeterol/fluticasone alone(control group, n=47) were enrolled into this clinical trial and were observed for six months. All patients were documented their information after inclusion. Health-related Quality of life was measured by CAT and lung function test was done at baseline, third month and sixth month. The events of acute exacerbation were also recorded. Results: No significant differences existed between the two groups at baseline. After 3 month and 6 month the average improvements(lower CAT scores and higher FEV1%) were significant in both observed group and control group(P<0.05), and there had been a greater improvement in observed group. There were good association between CAT score and FEV1%(-0.58 to -0.79). In patients with acute exacerbation more than once during the six month were associated with higher CAT scores(P<0.05). Conclusions: In patients with stable COPD, compared with therapy with salmeterol/fluticasone alone,tiotropium bromide combined with salmeterol/fluticasone is associated with lower CAT score, higher quality of life and fewer exacerbations, under such a situation where CAT is a reliable for assessing health-related quality of life of stable COPD patient.

参考文献:

[1] JONES P W,HARDING G,BERRY P,et al.Development and first validation of the COPD Assessment Test[J].Eur Respir J,2009, 34(3):648-654.
[2] 柴晶晶,柳涛,蔡柏蔷.慢性阻塞性肺疾病评估测试中文版临床应用意义的评价[J].中华结核和呼吸杂志,2011,34(4):256-258.
[3] PAUWELS R A,BUIST A S,MA P,et al.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:National Heart,Lung,and Blood Institute and World Health Organization Global Initiative for Chronic Obstructive Lung Disease(GOLD):executive summary[J].Respir Care,2001,46(8):798-825.
[4] .Standardization of spirometry,1994 update. american thoracic society[J].Am J Respir Crit Care Med,1995,152(3):1107-1136.
[5] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版)[J].中华结核和呼吸杂志,2007,30(1):8-17.
[6] ZHONG N S,WANG C H,YAO W Z,et al.Prevalence of chronic obstructive pulmonary disease in China:a large,population-based survey[J].Am J Respir Crit Care Med,2007,176(8):753-760.
[7] AARON S D,VANDEMHEEN K L,FERGUSSON D,et al.Tiotropium in combination with placebo,salmeterol,or fluticasone-salmeterol for treatment of chronic obstructive pulmonary disease:a randomized trial[J].Ann Intern Med,2007,146(8):545-555.
[8] JUNG K S,PARK H Y,PARK S Y,et al.Comparison of tiotropium plus fluticasone propionate/salmeterol with tiotropium in COPD:A randomized controlled study[J].Respir Med,2012, 106(3):382-389.
[9] HANANIA N A,CRATER G D,MORRIS A N,et al.Benefits of adding fluticasone propionate/salmeterol to tiotropium in moderate to severe COPD[J].Respir Med,2012, 106(1):91-101.
[10] VOGELMEIER C,HEDERER B,GLAAB T,et al.Tiotropium versus salmeterol for the prevention of exacerbations of COPD[J].N Engl J Med,2011,364(12):1093-1103.
[11] DALAL A A,CANDRILLI S D,DAVIS K L.Outcomes and costs associated with initial maintenance therapy with fluticasone propionate-salmeterol xinafoate 250 microg/50 microg combination versus tiotropium in commercially insured patients with COPD[J]. Manag Care,2011,20(8):46-50,53-55.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 186131 位访问者


copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-87232481 83272483
电子邮件:
bjb@pub.seu.edu.cn

苏ICP备09058364