The Changes Of Pulmonary Function And Inflammatory Factors In Patients With COPD Treated With Salmeterol/Fluticasone And Tiotropium Bromide

[Background]Chronic obstructive pulmonary disease(COPD)is a common,preventable and treatable condition characterized by persistent respiratory symptoms and restricted airflow,usually due to exposure to toxic particles or gases.Caused by airway and/or alveolar abnormalities.Patients had varying degrees of inflammatory response,and pulmonary function also decreased to varying degrees.In order to further improve the patient's pulmonary function,reduce the body's inflammatory response,prevent disease progression,and promote the body's recovery,the current domestic use of inhaled glucocorticoid(ICS),long-acting ?2 adrenergic receptor agonist(LABA),long-term M Body blocker(LAMA)combined with maintenance therapy.However,there are relatively few studies on the changes of pulmonary function and inflammatory factors in patients with COPD.[Objective]1.To observe the changes of pulmonary function in patients with COPD treated with salmeterol/fluticasone and tiotropium bromide.2.To observe the changes of serum inflammatory factors in patients with COPD treated with salmeterol/fluticasone and tiotropium bromide.3.To compare the differences in pulmonary function and serum inflammatory factors between patients with three drugs and salmeterol/fluticasone,and to provide reference for clinical use.[Methoded]120 patients with COPD were enrolled in our hospital from September 2017 to March 2019,and were randomly divided into 2 groups.60 patients in the control group were treated with salmeterol/fluticasone for 3 months.60 patients in the observation group were treated with salmeterol/fluticasone and tiotropium bromide for 3 months.The differences between the two groups before and after treatment were com pared between the dyspnea score(mMRC),the 6-minute walking distance(6-MWD),the blood gas index,the pulmonary function index,and the serum inflammatory factor index.The differences between the above parameters before and after treatment were compared between the groups.The observation group and the control group were compared with the data before and after treatment with independent sample t test,and the comparison between the groups before and after treatment was performed by paired t test.[resulted](1)mMRC:(1.05±0.06)points in the observation group and(1.95±0.11)points in the control group,the observation group was significantly lower than the control group,P<0.05.(2)6-MWD:(483.62±9.62)m after treatment and(384.26±5.55)m in the control group,the observation group was significantly higher than the control group,P<0.05.(3)Arterial blood gas index:Observation group PaCO2,PaO2,PH,SaO2,HCO3 were(44.25±1.52)mmHg,(70.95±3.99)mmHg,(7.41 ±0.06),(93.86±3.82)%,(21.05±1.06)mmol/L,the control group was(49.86±2.46)mmHg,(65.25±2.67)mmHg,(7.36±0.05),(91.26±4.11)%,(24.62±2.88)mmol/L,and treated for 3 months.PaCO2 and HCO3 in the post-observation group were significantly lower than those in the control group,and PaO2,PH and SaO2 were significantly higher than the control group,P<0.05.(4)Pulmonary function indicators:FEV1%pred,FEV1/FVC,FVC%pred,and VC%pred in the observation group were(54.25±4.81)%pred,(55.62±4.85)%,(80.85±3.81)%pred,(75.06± 1.31)%pred;control group were(49.36±2.31)%pred,(52.24±3.33)%,(76.45±4.51)%pred,(68.62 ± 3.25)%pred.After 3 months of treatment,FEV1%pred,FEV1/FVC,FVC%pred,,and VC%pred were significantly higher in the observation group than in the control group,P<0.05.(5)Serum inflammatory factor index:the observation group inhibited tumor necrosis factor-?(TNF-a),high-sensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8),and interleukin-6(IL-6)were(14.12± 1.05)pg/ml,(9.01 ±0.25)mg/L,(22.16± 1.02)pg/ml,(11.23± 1.52)pg/ml,respectively;the control group was(23.52±2.87).)pg/ml,(16.26 ±0.43)mg/L,(30.22 ± 2.54)pg/ml,(22.62 ± 2.31)pg/ml.The TNF-?,hs-CRP,IL-8 and IL-6 in the observation group were significantly lower than the control group,P<0.05.(6)incidence of adverse reactions:the incidence of adverse reactions in the observation group and the control group(5.00%,6.67%)compared,P>0.05.[Conclusion]salmeterol/fluticasone and tiotropium bromide can improve pulmonary function,inhibit the release of inflammatory mediators such as TNF-?,hs-CRP,IL-8 and IL-6,reduce the body's inflammatory response and relieve dyspnea.Enhance the endurance of activities and improve the quality of life of patients.