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目的观察稳定期老年慢性阻塞性肺疾病(COPD)患者长期吸入可必特气雾剂(异丙托溴胺和沙丁胺醇)后,分别测定对可必特、异丙托溴胺及沙丁胺醇的反应性。方法18例老年稳定期COPD患者吸入可必特气雾剂,每次2喷,3次/d,连续治疗12周,并在治疗前后分别应用可必特、异丙托溴胺及沙丁胺醇气雾剂作为支气管舒张剂行支气管舒张试验,在用药前后测定1s用力呼气容积(FEV1.0)及FEV1.0改善率(△FEV1.0)。结果患者在治疗后吸入可必特的△FEV1.0比治疗前下降(P<0.05),同样在治疗后吸入沙丁胺醇的△FEV1.0比治疗前下降(P<0.01),而吸入异丙托溴胺在治疗前后FEV1.0的改善不明显(P>0.05);在治疗前患者吸入可必特的△FEV1.0要比吸入沙丁胺醇及异丙托溴胺高(P<0.01),在治疗后患者吸入可必特后的△FEV1.0仍高于吸入沙丁胺醇(P<0.01),但与吸入异丙托溴胺相比,差异无统计学意义。结论老年稳定期COPD患者长期联用异丙托溴胺与沙丁胺醇,仍可造成其对沙丁胺醇的反应性低下,建议不要长期联用,采用胆碱能拮抗剂治疗老年COPD患者是一理想途径。
Objective To observe the long-term inhalation of essential aerosols (ipratropium bromide and salbutamol) in patients with stable chronic obstructive pulmonary disease (COPD) and determine their reactivity with butabant, ipratropium bromide and salbutamol . Methods Eighteen elderly patients with stable COPD were given inhaled essential aerosol for 2 weeks and 3 times per day for 12 weeks. Before and after treatment, they were given with ibuprofen, ipratropium bromide and albuterol aerosol respectively Bronchodilator bronchodilator bronchodilator test, measured before and after 1s forced expiratory volume (FEV1.0) and FEV1.0 improvement rate (△ FEV1.0). Results The △ FEV1.0 of inhaled patients after treatment was lower than before treatment (P <0.05). Similarly, the △ FEV1.0 of salbutamol inhaled after treatment was lower than before treatment (P <0.01) The improvement of FEV1.0 before and after treatment with bromine amine was not obvious (P> 0.05). Before treatment, the △ FEV1.0 of inhalation was higher than that of inhalation of albuterol and ipratropium bromide (P <0.01) After the inhalation of bebite patients △ FEV1.0 still higher than inhaled salbutamol (P <0.01), but compared with inhalation of ipratropium bromide, the difference was not statistically significant. Conclusion Long-term combined use of ipratropium bromide and salbutamol in elderly stable COPD patients may still lead to low reactivity to salbutamol. It is not recommended for long-term use, and cholinergic antagonists are an ideal way to treat elderly patients with COPD.