双联支气管扩张剂治疗症状型慢性阻塞性肺疾病患者的有效性和安全性

doi:10.3969/j.issn.1671-7171.2022.05.001

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摘要【目的】探讨双联支气管扩张剂(双支扩剂)长效β₂受体激动剂(LABA)和长效抗胆碱能药物(LAMA)治疗症状型慢性阻塞性肺疾病(COPD)患者的有效性和安全性。【方法】选取2018年12月至2021年1月在中南大学湘雅二医院和株洲市中心医院诊治、COPD评估测试(CAT)≥10分且首次使用LABA/LAMA治疗的COPD患者,按照入组前治疗方法不同分为初始组、原LAMA组、原吸入性糖皮质激素(inhaled corticosteroids, ICS)/LABA组、原ICS/LABA+LAMA组,所有纳入患者均采用LABA/LAMA治疗3个月,比较总体人群及各组LABA/LAMA治疗前后的CAT评分、急性加重率、临床控制率及不良反应发生情况。【结果】与治疗前比较,总体人群、初始组、原LAMA组、原ICS/LABA组使用LABA/LAMA治疗3个月后CAT评分均有明显改善(均P<0.05),急性加重率均有下降,临床控制率均显著提高(均P<0.05)。本研究总体不良反应发生率低。【结论】采用双支扩剂治疗症状型COPD患者,可改善患者的临床症状,降低急性加重率,提高临床控制率,且总体不良反应发生率低,值得临床推广应用。

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关键词 ：肺疾病,慢性阻塞性/药物疗法, 支气管扩张药/投药和剂量

Abstract：【Objective】 This study aimed to access the efficacy and safety of the medication use of long-acting β₂-agonist combined with long-acting muscarinic antagonist (LABA/LAMA) for symptomatic COPD patients in the real world. 【Methods】 Patients were enrolled in the study cohort if they were diagnosed as COPD with CAT≥10 scores and new to LAMA/LABA treatment from the Second Xiangya Hospital of Central South University and Zhuzhou Central Hospital during December 2018 and January 2021.Patients enrolled in the study treated with LABA/LAMA 3 for months. According to whether other maintenance medication was used before enrollment, they were divided into 4 groups: the initial group, prior LAMA group,prior ICS/LABA group,prior ICS/LABA plus LAMA group. The effectiveness outcome was the change of CAT scores, the occurrence of moderate to severe acute exacerbations and clinical control during follow-up. Safety outcome was the appearance of adverse effects. 【Results】 Overall study population and patients from the initial group, prior LAMA group, prior ICS/LABA group ameliorated significantly in CAT scores (P<0.05), After 3 months, LABA/LAMA significantly reduced the rate of moderate or severe exacerbations(P<0.05). Study showed a significant improvement in clinical control (P<0.05). The overall incidence of adverse events is low. 【Conclusion】 Patients with COPD symptoms benefit from LABA/LAMA by improving their clinical symptoms, reducing the rate of moderate or severe exacerbations and improving clinical control rates. LABA/LAMA is safe and well tolerated.

Key words： Pulmonary Disease, Chronic Obstructive/DT Bronchodilator Agents/AD

收稿日期: 2021-06-11

中图分类号:

R563

基金资助:国家自然科学基金(批号:81970044,81770046)

通讯作者: **E-mail:pingchen0731@csu.edu.cn

引用本文:

易荣, 许玉竹, 冯玲, 曾玉琴, 周军, 颜又新, 刘毅, 陈平. 双联支气管扩张剂治疗症状型慢性阻塞性肺疾病患者的有效性和安全性[J]. 医学临床研究, 2022, 39(5): 641-643.
YI Rong, XU Yu-zhu, FENG Ling, et al. Efficacy and Safety of Dual Bronchodilators (LABA/LAMA) for Treating Symptomatic COPD. JOURNAL OF CLINICAL RESEARCH, 2022, 39(5): 641-643.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.05.001 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I5/641