盐酸戊乙奎醚高浓度氧雾化吸入对慢性阻塞性肺病支气管扩张作用.doc

摘要】 目的 评价盐酸戊乙奎醚（长托宁）对慢性阻塞性肺病（COPD）的支气管扩张作用。方法 将92例COPD患者随机分为盐酸戊乙奎醚组31例，异丙托溴铵组34例，对照组27例,两个药物组吸入相应的药物，3组均吸入高浓度氧。测定所有患者用药前后第1秒用力呼气量（FEV1）变化。结果 盐酸戊乙奎醚组和异丙托溴铵组FEV1较用药前均有显著增加(P＜0.05)。以FEV1改善率 15%视为有效，此两组的有效率均高于80%，二者比较无显著差异 (P＞0.05)。对照组有效率低，与两个药物组比较差异显著(P＜0.05)。结论 抗胆碱能药物通过降低肺动脉压力而明显改善COPD患者通气功能。 【关键词】 盐酸戊乙奎醚；异丙托溴铵；慢性阻塞性肺疾病；肺功能 The bronchus expansion function of penehyclidine hydrochloride in patients with COPD 　　YANG Bo，Lü XiaoHong，SHENG Hui. 　　Department of Pulmonary Diseases，the First Hospital of Jilin University,Changchun 130021，Jilin, China 　　【Abstract】 Objective To evaluate the efficiency of penehyclidine hydrochloride in patients with chronic obstructive pulmonary disease (COPD). Methods Ninetytwo patients with COPD were randomly divided into three group： 31 patientsin penehyclidine hydrochloride, 34 ones in atrovent and 27 ones in control group. The patients in two drug groups inhaled corresponding drugs, all patients in three groups inhaled highconcentration oxygen. The forced expiratory volume in one second (FEV1) was measured before and after inhalation. Results FEV1 in two kinds of drug group were both improved after inhalation (P＜0.05). The efficiency of the two drugs were both higher than 80%, taking the improvement rate15% as effectiveness, but there was no significant difference between both (P0.05). The efficiency of control group was lower, being different from that of the drug groups (P＜0.05). Conclusions Penehyclidine hydrochloride can obviously improve the lung function of patients with COPD by reducing the pulmonary arterial pressure. 　　【Key words】 Penehyclidine hydrochloride；Atrovent；Chronic obstructive pulmonary disease；Lung function 　　慢性阻塞性肺病（COPD）是一种渐进性呼吸道疾病。与COPD相联系的慢性气流限制会导致在患者充分呼气后过多的气体滞留在肺脏内。这种气流阻塞表现缓慢进行，肺功能检查显示最大呼出量减少且持续数月没有变化。支气管扩张药在COPD的治疗中发挥重要作用，其中的抗胆碱能药物可能通过抑制正常的胆碱能介导的支气管舒缩紧张性起作用，盐酸戊乙奎醚作为一种抗胆碱能药物广泛应用于有机磷中毒和麻醉术中用药，我们将它与目前临床常用的抗胆碱能药物异丙托溴铵对COPD支气管扩张作用作一对比研究。 　　 　　1 资料与方法 　　1.1 对象 自2005年3月至2006年6月本院呼吸内科住院治疗的COPD患者(肺性脑病者除