Clinical Study Of SABA Responsiveness In Patients With COPD To Guide The Choice Of Bronchodilator

Objective:Through the dynamic observation of COPD patients,pulmonary function,clinical symptoms and a series of indicators,to investigate influence by the limited airflow reversible degree on the clinical significance of evaluation of inhaled drugs selection and curative effect in patients with COPD.Make COPD further individualized medication based on the guidelines.Methods:A total of 126 patients diagnosed moderate to severe COPD in our hospital in November 2015-November 2016 were divided into two groups(positive group n=60,negative group n=66)according to the different response of patients to short acting bronchodilator(SABA)in the process of pulmonary function test.The two groups was further divided into three subgroups according to the difference of inhaled drugs,namely ICS/LABA group,LAMA group and LABA group.The FEV1,FEV1%pred and CAT scores of each group were compared at the 0,2,4 and 6 months.All the collected data were analyzed with statistical software SPSS20.0.Results:1.In bronchial diastolic negative LABA group,FEV1%pred and CAT scores have no difference(P>0.05)when were compared before and after treatment.In bronchial diastolic positive,LAMA group,FEV1 and FEV1%pred have no difference(P>0.05)when were compared before and after treatment.FEV1、FEV1%pred and CAT scores in the other groups all were statistically significant(P<0.05).2.In the positive group,ICS/LABA and LABA improve FEV1,FEV1%pred and CAT scores were better than those in LAMA group(P<0.05).But the three indictors had no difference in ICS/LABA and LABA groups(P>0.05).3.In negative group,FEV1,FEV1%pred and CAT scores were better in LAMA group than that in LABA group(P<0.05).FEV1 and CAT scores between ICS/LABA and LAMA groups had no difference(P>0.05).FEV1 and FEV1%pred also had no difference(P>0.05)between ICS/LABA and LABA groups.4.Comparing between positive and negative groups,FEV1,FEV1%pred and CAT scores were better in positive LABA group than those in negative LABA group(P<0.05).FEV1,FEV1%pred and CAT scores were better in negative LAMA group than those in positive LAMA group(P<0.05).FEV1 had no difference(P>0.05)between positive and negative ICS/LABA groups.FEV1%pred and CAT scores were better in positive group than that in negative groups(P<0.05).Conclusions:1.The individual difference response to SABA in newly diagnosed COPD patients may be a phenotype of COPD,which may be helpful for the choice of bronchodilator.2.The application of β2 adrenergic agonists in these patients with good response to SABA has some advantages in promoting lung rehabilitation and reducing symptoms.