Effects of tiotropium bromide combined budesonide and formoterol by airway suction on airway inflammation and respiratory function in patients with chronic cor pulmonale at high altitude

doi:10.3877/cma.j.issn.1674-6902.2017.04.015

Abstract

Abstract:

Objective

To explore the Effects of tiotropium bromide combined budesonide and formoterol by airway suction on airway inflammation and respiratory function in patients with chronic cor pulmonale at high altitude(HACCP).

Methods

128 patients with HACCP were randomly divided into the observation group and control group, each group with 64 cases. The all patients in 2 groups received routine treatment of anti-infection, expectorant, theophylline, and oxygen therapy. The observation group received tiotropium bromide powder for inhalation (18 μg, once a day) combined budesonide/formoterol (160/5.4 μg, twice a day), and control group received alone tiotropium bromide powder for inhalation (18 μg, once a day) . All patients were examined for pulmonary function, arterial blood gas, level of induced sputum TNF-α, IL-6, 6MWD, and BODE index before and after 6 weeks treatment.

Results

after treatment, FEV₁% pred, FEV₁/FVC, PaO₂, 6 MWD in observation group and control group were both significantly higher [(45.3±6.7)%, (47.8±7.1)%, (51.5±5.8)mmHg, (421.5±52.8)m and(40.1±6.5)%, (43.4±6.7)%, (47.7±5.4)mmHg, (378.7±50.4)m, respectively] than those before treatment [(35.4±6.6)%, (39.3±7.1)%, (42.6±5.5)mmHg, (342.6±55.5)m and(34.9±6.4), (38.6±7.0)%, (42.0±5.5)mmHg), (340.5±52.4)m, respectively](all P<0.01). PaCO₂, level of induced sputum TNF-α, IL-6, and BODE index were both significantly lower[(47.8±5.8)mmHg, (35.7±6.7)ng/L, (27.5±5.4)ng/L, (4.4±0.8)and (51.2±5.6)mmHg, (40.3±6.4)ng/L, (31.2±5.6)ng/L, (5.2±0.8), respectively] than those before treatment [(56.8±6.1)mmHg, (48.6±6.6)ng/L, (35.5±6.2)ng/L, (6.1±0.9)and(56.1±5.9)mmHg, (47.9±6.2)ng/L, (34.9±6.6)ng/L, (6.0±0.8), respectively](all P<0.01), all parameters in observation group were different significantly Compared with those control group after treatment (all P<0.01). After treatment, 6 MWD in 128 patients was negative correlated with TNF-α and IL-6, positive correlated with FEV₁% pred, PaO₂ (all P<0.001), BODE index was positive correlated with TNF-α and IL-6, and negative correlated with FEV₁% pred and PaO₂ (all P<0.001).

Conclusions

The tiotropium bromide combined LABA+ ICS or pure tiotropium bromide by airway suction can significantly improve the airway inflammation, respiratory function, exercise endurance, and heath related quality of life in patients with HACCP . The effect of tiotropium bromide combined LABA+ ICS is more effective than pure tiotropium bromide.

Key words: Pulmonary disease, chronic obstructive, Chronic cor pulmonale, Respiratory function, Exercise endurance, Tiotropium bromide, Budesonide/Formoterol, High altitude

Enzhi Feng, Lixia Lin, He Yin, Shengyue Yang. Effects of tiotropium bromide combined budesonide and formoterol by airway suction on airway inflammation and respiratory function in patients with chronic cor pulmonale at high altitude[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(04): 436-440.

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组　别	例数	FEV₁% pred		FEV₁/FVC(%)		PaO₂(mmHg)		PaCO₂(mmHg)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	64	35.4±6.6	45.3±6.7^a	39.3±7.1	47.8±7.1^a	42.6±5.5	51.5±5.8^a	56.8±6.1	47.8±5.8^a
对照组	64	34.9±6.4	40.1±6.5^a	38.6±7.0	43.4±6.7^a	42.0±5.5	47.7±5.4^a	56.1±5.9	51.2±5.6^a
t值	?	0.435	2.782	0.556	2.764	0.609	3.756	0.649	3.426
P值	?	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01

组　别	例数	FEV₁% pred		FEV₁/FVC(%)		PaO₂(mmHg)		PaCO₂(mmHg)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	64	35.4±6.6	45.3±6.7^a	39.3±7.1	47.8±7.1^a	42.6±5.5	51.5±5.8^a	56.8±6.1	47.8±5.8^a
对照组	64	34.9±6.4	40.1±6.5^a	38.6±7.0	43.4±6.7^a	42.0±5.5	47.7±5.4^a	56.1±5.9	51.2±5.6^a
t值	?	0.435	2.782	0.556	2.764	0.609	3.756	0.649	3.426
P值	?	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01

组　别	例数	TNF-α((ng/L))		IL-6((ng/L)		6 MWD(m)		BODE指数
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	64	48.6±6.6	35.7±6.7^a	35.5±6.2	27.5±5.4^a	342.6±55.5	421.5±52.8^a	6.1±0.9	4.4±0.8^a
对照组	64	47.9±6.2	40.3±6.4^a	34.9±6.6	31.2±5.6^a	340.5±52.4	378.7±50.4^a	6.0±0.8	5.2±0.8^a
t值	?	0.635	4.528	0.513	3.767	0.239	4.712	0.661	4.257
P值	?	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01

组　别	例数	TNF-α((ng/L))		IL-6((ng/L)		6 MWD(m)		BODE指数
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	64	48.6±6.6	35.7±6.7^a	35.5±6.2	27.5±5.4^a	342.6±55.5	421.5±52.8^a	6.1±0.9	4.4±0.8^a
对照组	64	47.9±6.2	40.3±6.4^a	34.9±6.6	31.2±5.6^a	340.5±52.4	378.7±50.4^a	6.0±0.8	5.2±0.8^a
t值	?	0.635	4.528	0.513	3.767	0.239	4.712	0.661	4.257
P值	?	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01

指　标	TNF-α		IL-6		FEV₁% pred		PaO₂
指　标	r值	P值	r值	P值	r值	P值	r值	P值
6 MWD	－0.613	<0.001	－0.548	<0.001	0.502	<0.001	0.724	<0.001
BODE指数	0.598	<0.001	0.551	<0.001	－0.518	<0.001	－0.628	<0.001

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