内科

目的探讨噻托溴铵联合沙美特罗丙酸氟替卡松（舒利迭）治疗对慢性阻塞性肺疾病（COPD）急性加重期患者肺功能及C反应蛋白（CRP）的影响。方法将COPD患者50例随机分为对照组和观察组，对照组患者采用静脉用抗生素、二羟丙茶碱，口服多索茶碱、止咳、雾化祛痰等常规治疗加沙美特罗丙酸氟替卡松吸入治疗；观察组患者在同对照组患者治疗的基础上联合噻托溴铵干粉吸入治疗。两组患者疗程均为7个月。检测比较两组患者治疗前后的肺功能和CRP的变化。结果与治疗前比较，两组患者的肺功能指标FEVl、FVC、FEV1/FVC均明显改善（P＜0.01），CRP含量均显著降低（P＜0.01）。与对照组患者比较，观察组患者肺功能各项指标改善更明显，两组比较差异有统计学意义（P＜0.05），观察组患者CRP降低幅度大于对照组患者，两组比较差异有统计学意义（P＜0.01）。结论噻托溴铵联合舒利迭吸入治疗COPD，能更明显地减轻患者气道高反应性，抑制炎症介质，改善患者肺功能。

ObjectiveTo investigate the influence of tiotropium bromide combined salmeterol fluticasone for in acute exacerbations COPD Patients＇lung Function and CRP. Methods50 cases of COPD patients were randomly divided into control group and observation group, with 25 cases each,the control group was treated with conventional treatment combined with salmeterol fluticasone, the conventional treatment contain antibiotics, 2 hydroxypropyl theophylline, intravenous infusion; doxofylline, apophlegmasant and antitussive, oral; and the observation group gets an additional treatment by applying tiotropium bromide,the course of the treatments were 7 months. The lung function and CRP in both groups were detected and compared before and after treatment. ResultsThe indexes of lung function (FEVl, FVC, FEVl/FVC) were improved significantly after treatment in both two groups (P＜0.01), and the levels of CRP in the two groups were significantly lower than before treatment(P＜0.01), but the improvement of the observation group is better than that of the control group, there was significant difference between two groups.(P＜0.05). ConclusionsTiotropium bromide combined salmeterol fluticasone for COPD patients can effectivly relieve hyperresponsiveness, inhibit inflammatory mediators, improve the patient＇s lung function.