目的 探討布地格福吸入氣霧劑聯(lián)合茶堿治療慢性阻塞性肺疾?。–OPD）穩(wěn)定期的臨床效果。方法 選取2020年1月—2021年3月天津市第五中心醫(yī)院收治的96例COPD穩(wěn)定期患者，隨機分為對照組（48例）和治療組（48例）。對照組口服茶堿緩釋片，1片/次，2次/d。治療組在對照組基礎(chǔ)上經(jīng)口吸入布地格福吸入氣霧劑，2撳/次，2次/d。兩組患者連續(xù)治療12周。觀察兩組患者臨床療效，比較治療前后兩組患者6 min步行距離（6MWD）、自我評估測試（CAT）問卷、St George’s呼吸問卷（SGRQ）評分、肺功能參數(shù)第1秒用力呼氣容積（FEV1）、FEV1與用力肺活量（FVC）比值（FEV1/FVC）、一氧化碳彌散量（DLCO）占預(yù)計值百分?jǐn)?shù)、FEV1占預(yù)計值百分?jǐn)?shù)和殘氣容積（RV）與肺總量（TLC）比值（RV/TLC）及呼出氣一氧化氮（FeNO）濃度、外周血輔助性T細(xì)胞（Th）1與Th2比值（Th1/Th2）、血清基質(zhì)金屬蛋白酶-9（MMP-9）和白細(xì)胞介素-18（IL-18）水平。結(jié)果 治療后，治療組總有效率為95.8%，顯著高于對照組的83.3%（P<0.05）。治療后，兩組6MWD均較治療前顯著增加（P<0.05），CAT問卷和SGRQ評分顯著降低（P<0.05），且治療組的6MWD和CAT問卷、SGRQ評分比對照組改善更顯著（P<0.05）。治療后，兩組FEV1、FEV1/FVC、DLCO占預(yù)計值百分?jǐn)?shù)及FEV1占預(yù)計值百分?jǐn)?shù)均較治療前顯著升高（P<0.05），RV/TLC顯著降低（P<0.05），且治療組肺功能明顯好于對照組（P<0.05）。治療后，兩組FeNO、外周血Th1/Th2及血清MMP-9、IL-18水平均顯著下降（P<0.05），且治療組降低更明顯（P<0.05）。結(jié)論 布地格福吸入氣霧劑聯(lián)合茶堿治療COPD穩(wěn)定期整體效果顯著，能安全有效地改善患者癥狀、生活質(zhì)量及肺功能，具有一定臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with theophylline in treatment of chronic obstructive pulmonary disease in stable phase. Methods Patients (96 cases) with chronic obstructive pulmonary disease in stable phase in Tianjin Fifth Central Hospital from January 2020 to March 2021 were randomly divided into control (48 cases) and treatment (48 cases) groups. Patients in the control group were po administered with Theophylline Sustained-release Tablets, 1 tablet/time, twice daily. Patients in the treatment group were oral inhalation administered with Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol, 2 press/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, the 6MWD and CAT questionnaires and SGRQ scores, pulmonary function parameters of FEV1, FEV1/FVC, percentage of DLCO in estimated value, percentage of FEV1 in estimated value and RV/TLC, and FeNO concentration, peripheral blood Th1/Th2 and serum MMP-9 and IL-18 levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 95.8%, which was significantly higher than that of the control group (83.3%) (P<0.05). After treatment, 6MWD in two groups were significantly increased, CAT questionnaire and SGRQ scores were significantly decreased, and 6MWD, CAT questionnaire and SGRQ scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the FEV1, FEV1/FVC, percentage of DLCO in estimated value, percentage of FEV1 in estimated value of two groups were significantly higher than those before treatment, while RV/TLC were significantly decreased (P<0.05), and the pulmonary function of the treatment group was significantly better than that of the control group (P<0.05). After treatment, the concentration of FeNO, the level of Th1/Th2 in peripheral blood and the level of MMP-9 and IL-18 in serum were significantly decreased in two groups (P<0.05), especially in the treatment group (P<0.05) .Conclusion The overall effect of Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with theophylline in treatment of chronic obstructive pulmonary disease in stable phase is remarkable, and it can safely and effectively improve patients' symptoms, quality of life and pulmonary function, which has a certain clinical application value.

R974