Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to th...Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to the hospital between June 2020 and December 2022 were selected as samples for this study.The patients were divided into a combination group and a conventional group using the random number table method,with 31 cases in each group.The patients in the combination group were treated with TB combined with BUD/FM inhalation,whereas the patients in the conventional group were treated with BUD/FM inhalation only.The treatment efficacy and changes in lung function indicators of both groups were compared.Results:The total efficacy of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there was no difference in pulmonary function indicators between the two groups(P>0.05).After three months of treatment,all lung function indicators of the combined group were higher than those of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Combining TB with BUD/FM inhalation therapy increases the efficacy of treatment for patients with COPD.Besides,it also improves lung function and leads to a better prognosis.展开更多
Background: The use of anticholinergics has been on the rise. With the increase in population longevity, more medication-related cognitive impairments (ACIs) have been reported. These impairments result in significant...Background: The use of anticholinergics has been on the rise. With the increase in population longevity, more medication-related cognitive impairments (ACIs) have been reported. These impairments result in significant morbidities. We present a case that stresses on the importance of being vigilant when prescribing anticholinergic medications, especially in the elderlies. Case Report: A case of ACIs related to the use of tiotropium bromide/olodaterol (Stiolto Respimat) is being reported in a 71-year-old white man with COPD. Treatment with budesonide 180 mcg/actuation, and tiotropium bromide/olodaterol (Stiolto Respimat) inhalers was initiated. Two days after initiating treatment, the patient developed ACIs which manifested by gait imbalance, short-term memory dysfunction, inability to remember his family members, or to take his medications. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued. After three days, a full recovery of ACIs was reported. A month later, due to worsening dyspnea, the patient self-resumed the medicine. Similar ACIs were reported within two days of resuming treatment. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued indefinitely. Full recovery of ACIs was reported. Conclusion: ACIs should be noted as a significant side effect of tiotropium bromide/olodaterol. Clinicians should be vigilant, when prescribing anticholinergic medications to elderlies.展开更多
Objective:To explore the feasibility of tiotropium bromide therapy and its effect on the lung function of patients with asthma-COPD overlap syndrome(ACOS).Method:The 58 subjects selected in this study were all ACOS pa...Objective:To explore the feasibility of tiotropium bromide therapy and its effect on the lung function of patients with asthma-COPD overlap syndrome(ACOS).Method:The 58 subjects selected in this study were all ACOS patients admitted to our hospital(Hohhot First Hospital)from October 2020 to October 2022.They were grouped according to the random number table method and divided into a control group(29 cases)and an observation group(29 cases).The control group received routine treatment plus salmeterol-fluticasone powder inhalation treatment,and the observation group received tiotropium bromide treatment.The relevant indicators of the two groups were compared.Results:The total clinical effective rate of the observation group was significantly higher than that of the control group.Besides,the forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1)levels,and ACT scores of the two groups increased after treatment,with the observation group having better results than the control group.The residual volume-total lung capacity ratio(RV/TLC),acute exacerbation frequency,and CAT scores all decreased,with the observation group showing smaller values than the control group.The difference between the results of both groups were significant(P<0.05)Conclusion:Tiotropium bromide has a significant clinical effect in the treatment of ACOS patients and can effectively improve the lung function of patients.展开更多
Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD)....Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.展开更多
This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-c...This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder （18 μg/day） or oral doxofylline tablets （0.2 g/time, 2 times a day） for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV1, FEV1/FVC% and 6-min walk distance were sig-nificantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases （9.9%） and 12 cases （12.9%）, respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day （two times a day） are effective and safe for the treatment of COPD.展开更多
The expression of CD8＋CD25＋FoxP3＋ regulatory T cells（CD8＋Tregs） in the peripheral blood of patients with stable chronic obstructive pulmonary disease（COPD）,and the effect of muscarinic cholinergic receptor ant...The expression of CD8＋CD25＋FoxP3＋ regulatory T cells（CD8＋Tregs） in the peripheral blood of patients with stable chronic obstructive pulmonary disease（COPD）,and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8＋Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide（18 μg daily） for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoclonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8＋T cells,CD8＋CD25＋T cells,CD8＋Tregs,CD4＋T cells,CD4＋CD25＋T cells and CD4＋CD25＋FoxP3＋ regulatory T cells（CD4＋Tregs） respectively.The percentage of CD4＋T cells was increased from（27.82±2.18）% to（35.53±1.3）%（t=3.20,P=0.004） in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4＋CD25＋T cells was decreased from（10.03 ±1.42）% to（4.21 ±0.65）%（t=3.78,P=0.001）,and that of CD8＋Tregs was increased from（8.41 ±1.68）% to（21.34 ±4.20）%（t=2.72,P=0.013）.At baseline,CD8＋T cells,CD8＋CD25＋T cells and CD4＋Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4＋T cells and CD4＋CD25＋T cells was negatively correlated with the ratio of change in CD8＋Tregs before and after treatment（r=-0.61,P=0.013;r=-0.72,P=0.001 respectively）.In the peripheral blood of patients with stable COPD,there was the expression of CD8＋Tregs and CD4＋Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4＋T cells,inhibit the expression of CD25＋T cells,and enhance the expression of CD8＋Tregs.CD8＋Tregs and CD4＋Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.展开更多
Objective:To study the M receptor blocker on inhalation in patients with overlap syndrome(chronic obstructive pulmonary disease and Obstructive sleep apnea syndrome)curative effect analysis.Methods:25 patients with ov...Objective:To study the M receptor blocker on inhalation in patients with overlap syndrome(chronic obstructive pulmonary disease and Obstructive sleep apnea syndrome)curative effect analysis.Methods:25 patients with overlap syndrome as the experimental group,chronic obstructive pulmonary disease patients(30)as control group,patients with overlap syndrome use inhaled tiotropium powder treat 30 days,to observe the changes of pulmonary function,polysomnography,and other indicators after treatment.Results:Overlap syndrome were treated by tiotropium bromide inhalation powder,has improved the pulmonary function,the sleep apnea index and lowest nocturnal oxygen saturation after treatment.Conclusion:tiotropium bromide has a preferable effective in treatment of overlap syndrome,COPD and OSAHS are interacting with each other.展开更多
Background: The purpose of this study was to evaluate the effectiveness of perioperative tiotropium therapy for patients undergoing pulmonary resection for primary lung cancer. The short-term tiotropium effect was inv...Background: The purpose of this study was to evaluate the effectiveness of perioperative tiotropium therapy for patients undergoing pulmonary resection for primary lung cancer. The short-term tiotropium effect was investigated by perioperative pulmonary function and “lung age”. Methods: The fifty-five patients who underwent a lobectomy and had tiotropium treatment available from October 2007 through May 2009 were the subjects. The patients were divided into 3 groups according to their airway limitation such as Chronic Obstructive Pulmonary Disease (COPD) or a history of smoking;those with COPD (%FEV1 ≤70%, C-group, n = 22), smokers (%FEV1 > 70%, S-group, n = 10) and non-smokers (%FEV1 > 70%, N-group, n = 23). As the bronchodilator groups, the C- and S-groups received inhaled tiotropium bromide (18 μg once daily) for 1 week before surgery until at least 3 weeks after surgery without interruption, and as a control, the N-group had no treatment. The preoperative baselines, the predicted postoperative values, and the actual postoperative ones were measured by the pulmonary function test. The changed rates were calculated and denoted as ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC, from the baseline of the predicted postoperative values. The mean “real age” and “lung age” were calculated. Results: In the S-group, the parameters of ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC significantly increased compared to those of the N-group. In the C-group, the increased extents of ΔFEV1 and ΔFEV1/FVC were lower compared to those in the S-group (not significant). In the N-group, the parameters of ΔVC, ΔFEV1, and ΔVC% decreased. The postoperative “lung age” and “real age” were increased to 29.5 ± 18.0 year-old in the C-group, 25.8 ± 18.0 in the S-group, and 24.7 ± 17.0 in the N-group. Lung resection affected the “lung age”;the aging was a 28.9 ± 12.7 year-old increase in the N-group. In the C- and S-group, the “lung age” was a 14-year-old increase. The effect of tiotropium treatment affected the “lung age” as a 15-year-old increase. Conclusion: Perioperative interventional tiotropium contributed to the lobectomy patients with COPD and for smokers with a non-obstructive airway and played a role of preserving the postoperative lung function.展开更多
Objective: To observe the clinical effect of tiotropium bromide in elderly patients with COPD at stable stage and its effects on pulmonary function,blood and serum inflammatory cytokine. Methods: 80 elderly patients w...Objective: To observe the clinical effect of tiotropium bromide in elderly patients with COPD at stable stage and its effects on pulmonary function,blood and serum inflammatory cytokine. Methods: 80 elderly patients with COPD s at stable stage were randomly divided into treatment group and control group with 40 patients in each group. The control group was treated with normal treatment. The treatment group was treated with tiotropium bromide on the basis of control group. 3 months after treatment, the pulmonary function、arterial blood gas and serum inflammatory cytokine were detected and compared in the two groups. Results:There was no significant difference in lung function index and TNF- alpha level between the two groups before treatment (P>0.05). The levels of FVC, FEV1% and PEF were increased and serum TNF-α was decreased significantly after treatment in two groups (P<0.05), and they were better than in treatment group than those in control group (all P<0.05);There was no significant difference in blood gas index between the two groups before treatment (P>0.05);In addition, there were no significant difference in the level of PCT, PaO2, PaCO2 and PaO2/FiO2 after treatment in control group, but the level of PCT and PaCO2 were higher and PaO2 and PaO2/FiO2 were lower obviously after treatment (P<0.01). The treatment group was superior to the control group (all P<0.05);Moreover, the curative effect of treatment group was better than that in control group (P<0.05). Conclusion: Tiotropium bromide can improve pulmonary function, pulmonary function、arterial blood gas and serum inflammatory cytokine in elderly stable COPD patients.展开更多
Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with C...Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with COPD and type II respiratory failure treated in our hospital between August 2012 and January 2016 were collected and divided into observation group (n=29) and control group (n=29) according to the single blind randomized control method. Control group of patients received clinical routine treatment, and observation group of patients received adjuvant tiotropium bromide treatment on the basis of routine treatment. Before treatment and 30d after treatment, spirometer was used to determine pulmonary ventilation function;blood gas analyzer was used to test oxygenation function indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect serum inflammatory factor levels.Results: Before treatment, differences in pulmonary ventilation function, oxygenation function and serum inflammatory factor levels were not statistically significant between two groups of patients. 30 d after treatment, FEV1, FEF75%, PEF, PaO2/FiO2, DO2 and O2ER levels of observation group were significantly higher than those of control group while VO2 level was significantly lower than that of control group;serum IL-1β, IL-18, IL-27 and CRP levels were significantly lower than those of control group.Conclusion:Adjuvant tiotropium bromide treatment can optimize the pulmonary ventilation and oxygenation function and reduce systemic inflammatory response in patients with COPD and type II respiratory failure.展开更多
Objective: To study the effects of symbicort turbuhaler combined with tiotropium bromide on serum PCT, TIMP-1, MMP-9, IFN-γ, arterial blood gases and pulmonary function in patients with AECOPD. Methods A total of 90 ...Objective: To study the effects of symbicort turbuhaler combined with tiotropium bromide on serum PCT, TIMP-1, MMP-9, IFN-γ, arterial blood gases and pulmonary function in patients with AECOPD. Methods A total of 90 patients in our hospital with AECOPD during January 2014 to January 2017 were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group was treated with tiotropium bromide;the treatment group was treated with symbicort turbuhaler combined with tiotropium bromide. The two groups were treated for 14 d. That was compared of the serum PCT, TIMP-1, MMP-9, IFN-γ, PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the two groups before and after treatment. Results The serum PCT, TIMP-1, MMP-9, IFN-γ, PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the two groups before treatment have no significantly differences. The serum PCT, TIMP-1, MMP-9 and IFN-γ levels of the two groups after treatment were significantly lower than before treatment. The serum PCT, TIMP-1, MMP-9 and IFN-γ levels of the treatment group after treatment were significantly lower than the control group. The PaO2, SaO2 of the two groups after treatment were significantly higher than before treatment, the PaCO2, MPAP, PASP and PADP of the two groups after treatment were significantly lower than before treatment. The PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the treatment group after treatment were significantly better than the control group. Conclusion Symbicort turbuhaler combined with tiotropium bromide can reduce the serum PCT, TIMP-1, MMP-9, IFN-γlevels and the pulmonary arterial hypertension, improve the lung tissue oxygen supply and the cardiopulmonary function, and it was worthy clinical application.展开更多
Inhaled anticholinergic agent tiotropium is widely used in the treatment of chronic obstructive pulmonary disease（COPD）. However, it has pro-arrhythmic and pro-ischaemic effects, which can potentially increase the r...Inhaled anticholinergic agent tiotropium is widely used in the treatment of chronic obstructive pulmonary disease（COPD）. However, it has pro-arrhythmic and pro-ischaemic effects, which can potentially increase the risk of serious cardiovascular events, especially in patients with pre-existing arrhythmias. We presented a 79-year-old man with a medical history of arrhythmia, who developed atrial fibrillation after used tiotropium 18 μg daily for two weeks. We urge the caution of pro-arrhythmic effect of tiotropium. Healthcare professionals should be aware of the potential effect when prescribing tiotropium to patients with known cardiac rhythm disorders.展开更多
文摘Objective:To analyze the clinical efficacy of tiotropium bromide(TB)combined with budesonide formoterol(BUD/FM)inhalation in treating chronic obstructive pulmonary disease(COPD).Methods:62 COPD patients admitted to the hospital between June 2020 and December 2022 were selected as samples for this study.The patients were divided into a combination group and a conventional group using the random number table method,with 31 cases in each group.The patients in the combination group were treated with TB combined with BUD/FM inhalation,whereas the patients in the conventional group were treated with BUD/FM inhalation only.The treatment efficacy and changes in lung function indicators of both groups were compared.Results:The total efficacy of treatment in the combined group was higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there was no difference in pulmonary function indicators between the two groups(P>0.05).After three months of treatment,all lung function indicators of the combined group were higher than those of the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Combining TB with BUD/FM inhalation therapy increases the efficacy of treatment for patients with COPD.Besides,it also improves lung function and leads to a better prognosis.
文摘Background: The use of anticholinergics has been on the rise. With the increase in population longevity, more medication-related cognitive impairments (ACIs) have been reported. These impairments result in significant morbidities. We present a case that stresses on the importance of being vigilant when prescribing anticholinergic medications, especially in the elderlies. Case Report: A case of ACIs related to the use of tiotropium bromide/olodaterol (Stiolto Respimat) is being reported in a 71-year-old white man with COPD. Treatment with budesonide 180 mcg/actuation, and tiotropium bromide/olodaterol (Stiolto Respimat) inhalers was initiated. Two days after initiating treatment, the patient developed ACIs which manifested by gait imbalance, short-term memory dysfunction, inability to remember his family members, or to take his medications. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued. After three days, a full recovery of ACIs was reported. A month later, due to worsening dyspnea, the patient self-resumed the medicine. Similar ACIs were reported within two days of resuming treatment. Tiotropium bromide/olodaterol (Stiolto Respimat) was discontinued indefinitely. Full recovery of ACIs was reported. Conclusion: ACIs should be noted as a significant side effect of tiotropium bromide/olodaterol. Clinicians should be vigilant, when prescribing anticholinergic medications to elderlies.
文摘Objective:To explore the feasibility of tiotropium bromide therapy and its effect on the lung function of patients with asthma-COPD overlap syndrome(ACOS).Method:The 58 subjects selected in this study were all ACOS patients admitted to our hospital(Hohhot First Hospital)from October 2020 to October 2022.They were grouped according to the random number table method and divided into a control group(29 cases)and an observation group(29 cases).The control group received routine treatment plus salmeterol-fluticasone powder inhalation treatment,and the observation group received tiotropium bromide treatment.The relevant indicators of the two groups were compared.Results:The total clinical effective rate of the observation group was significantly higher than that of the control group.Besides,the forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1)levels,and ACT scores of the two groups increased after treatment,with the observation group having better results than the control group.The residual volume-total lung capacity ratio(RV/TLC),acute exacerbation frequency,and CAT scores all decreased,with the observation group showing smaller values than the control group.The difference between the results of both groups were significant(P<0.05)Conclusion:Tiotropium bromide has a significant clinical effect in the treatment of ACOS patients and can effectively improve the lung function of patients.
文摘Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.
基金supported by grants from the Clinical Chronic Respiratory Diseases Research Foundation of Chinese Medical Association (No. 07010030011)Key Research Program of the Ministry of Health of China (No. 2007353)the Special Funds for Scientific Research on Public Causes of Ministry of Health of China (No. 201002008)
文摘This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder （18 μg/day） or oral doxofylline tablets （0.2 g/time, 2 times a day） for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV1, FEV1/FVC% and 6-min walk distance were sig-nificantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases （9.9%） and 12 cases （12.9%）, respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day （two times a day） are effective and safe for the treatment of COPD.
基金supported by a grant from New Teacher Project of Doctor-station Foundation of Ministry of Education (No.20070487154)
文摘The expression of CD8＋CD25＋FoxP3＋ regulatory T cells（CD8＋Tregs） in the peripheral blood of patients with stable chronic obstructive pulmonary disease（COPD）,and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8＋Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide（18 μg daily） for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoclonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8＋T cells,CD8＋CD25＋T cells,CD8＋Tregs,CD4＋T cells,CD4＋CD25＋T cells and CD4＋CD25＋FoxP3＋ regulatory T cells（CD4＋Tregs） respectively.The percentage of CD4＋T cells was increased from（27.82±2.18）% to（35.53±1.3）%（t=3.20,P=0.004） in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4＋CD25＋T cells was decreased from（10.03 ±1.42）% to（4.21 ±0.65）%（t=3.78,P=0.001）,and that of CD8＋Tregs was increased from（8.41 ±1.68）% to（21.34 ±4.20）%（t=2.72,P=0.013）.At baseline,CD8＋T cells,CD8＋CD25＋T cells and CD4＋Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4＋T cells and CD4＋CD25＋T cells was negatively correlated with the ratio of change in CD8＋Tregs before and after treatment（r=-0.61,P=0.013;r=-0.72,P=0.001 respectively）.In the peripheral blood of patients with stable COPD,there was the expression of CD8＋Tregs and CD4＋Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4＋T cells,inhibit the expression of CD25＋T cells,and enhance the expression of CD8＋Tregs.CD8＋Tregs and CD4＋Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.
文摘Objective:To study the M receptor blocker on inhalation in patients with overlap syndrome(chronic obstructive pulmonary disease and Obstructive sleep apnea syndrome)curative effect analysis.Methods:25 patients with overlap syndrome as the experimental group,chronic obstructive pulmonary disease patients(30)as control group,patients with overlap syndrome use inhaled tiotropium powder treat 30 days,to observe the changes of pulmonary function,polysomnography,and other indicators after treatment.Results:Overlap syndrome were treated by tiotropium bromide inhalation powder,has improved the pulmonary function,the sleep apnea index and lowest nocturnal oxygen saturation after treatment.Conclusion:tiotropium bromide has a preferable effective in treatment of overlap syndrome,COPD and OSAHS are interacting with each other.
文摘Background: The purpose of this study was to evaluate the effectiveness of perioperative tiotropium therapy for patients undergoing pulmonary resection for primary lung cancer. The short-term tiotropium effect was investigated by perioperative pulmonary function and “lung age”. Methods: The fifty-five patients who underwent a lobectomy and had tiotropium treatment available from October 2007 through May 2009 were the subjects. The patients were divided into 3 groups according to their airway limitation such as Chronic Obstructive Pulmonary Disease (COPD) or a history of smoking;those with COPD (%FEV1 ≤70%, C-group, n = 22), smokers (%FEV1 > 70%, S-group, n = 10) and non-smokers (%FEV1 > 70%, N-group, n = 23). As the bronchodilator groups, the C- and S-groups received inhaled tiotropium bromide (18 μg once daily) for 1 week before surgery until at least 3 weeks after surgery without interruption, and as a control, the N-group had no treatment. The preoperative baselines, the predicted postoperative values, and the actual postoperative ones were measured by the pulmonary function test. The changed rates were calculated and denoted as ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC, from the baseline of the predicted postoperative values. The mean “real age” and “lung age” were calculated. Results: In the S-group, the parameters of ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC significantly increased compared to those of the N-group. In the C-group, the increased extents of ΔFEV1 and ΔFEV1/FVC were lower compared to those in the S-group (not significant). In the N-group, the parameters of ΔVC, ΔFEV1, and ΔVC% decreased. The postoperative “lung age” and “real age” were increased to 29.5 ± 18.0 year-old in the C-group, 25.8 ± 18.0 in the S-group, and 24.7 ± 17.0 in the N-group. Lung resection affected the “lung age”;the aging was a 28.9 ± 12.7 year-old increase in the N-group. In the C- and S-group, the “lung age” was a 14-year-old increase. The effect of tiotropium treatment affected the “lung age” as a 15-year-old increase. Conclusion: Perioperative interventional tiotropium contributed to the lobectomy patients with COPD and for smokers with a non-obstructive airway and played a role of preserving the postoperative lung function.
文摘Objective: To observe the clinical effect of tiotropium bromide in elderly patients with COPD at stable stage and its effects on pulmonary function,blood and serum inflammatory cytokine. Methods: 80 elderly patients with COPD s at stable stage were randomly divided into treatment group and control group with 40 patients in each group. The control group was treated with normal treatment. The treatment group was treated with tiotropium bromide on the basis of control group. 3 months after treatment, the pulmonary function、arterial blood gas and serum inflammatory cytokine were detected and compared in the two groups. Results:There was no significant difference in lung function index and TNF- alpha level between the two groups before treatment (P>0.05). The levels of FVC, FEV1% and PEF were increased and serum TNF-α was decreased significantly after treatment in two groups (P<0.05), and they were better than in treatment group than those in control group (all P<0.05);There was no significant difference in blood gas index between the two groups before treatment (P>0.05);In addition, there were no significant difference in the level of PCT, PaO2, PaCO2 and PaO2/FiO2 after treatment in control group, but the level of PCT and PaCO2 were higher and PaO2 and PaO2/FiO2 were lower obviously after treatment (P<0.01). The treatment group was superior to the control group (all P<0.05);Moreover, the curative effect of treatment group was better than that in control group (P<0.05). Conclusion: Tiotropium bromide can improve pulmonary function, pulmonary function、arterial blood gas and serum inflammatory cytokine in elderly stable COPD patients.
文摘Objective:To explore the effect of adjuvant tiotropium bromide therapy on the oxygenation function and inflammatory response in patients with COPD and type Ⅱ respiratory failure. Methods:a total of 58 patients with COPD and type II respiratory failure treated in our hospital between August 2012 and January 2016 were collected and divided into observation group (n=29) and control group (n=29) according to the single blind randomized control method. Control group of patients received clinical routine treatment, and observation group of patients received adjuvant tiotropium bromide treatment on the basis of routine treatment. Before treatment and 30d after treatment, spirometer was used to determine pulmonary ventilation function;blood gas analyzer was used to test oxygenation function indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect serum inflammatory factor levels.Results: Before treatment, differences in pulmonary ventilation function, oxygenation function and serum inflammatory factor levels were not statistically significant between two groups of patients. 30 d after treatment, FEV1, FEF75%, PEF, PaO2/FiO2, DO2 and O2ER levels of observation group were significantly higher than those of control group while VO2 level was significantly lower than that of control group;serum IL-1β, IL-18, IL-27 and CRP levels were significantly lower than those of control group.Conclusion:Adjuvant tiotropium bromide treatment can optimize the pulmonary ventilation and oxygenation function and reduce systemic inflammatory response in patients with COPD and type II respiratory failure.
文摘Objective: To study the effects of symbicort turbuhaler combined with tiotropium bromide on serum PCT, TIMP-1, MMP-9, IFN-γ, arterial blood gases and pulmonary function in patients with AECOPD. Methods A total of 90 patients in our hospital with AECOPD during January 2014 to January 2017 were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group was treated with tiotropium bromide;the treatment group was treated with symbicort turbuhaler combined with tiotropium bromide. The two groups were treated for 14 d. That was compared of the serum PCT, TIMP-1, MMP-9, IFN-γ, PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the two groups before and after treatment. Results The serum PCT, TIMP-1, MMP-9, IFN-γ, PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the two groups before treatment have no significantly differences. The serum PCT, TIMP-1, MMP-9 and IFN-γ levels of the two groups after treatment were significantly lower than before treatment. The serum PCT, TIMP-1, MMP-9 and IFN-γ levels of the treatment group after treatment were significantly lower than the control group. The PaO2, SaO2 of the two groups after treatment were significantly higher than before treatment, the PaCO2, MPAP, PASP and PADP of the two groups after treatment were significantly lower than before treatment. The PaO2, SaO2, PaCO2, MPAP, PASP and PADP of the treatment group after treatment were significantly better than the control group. Conclusion Symbicort turbuhaler combined with tiotropium bromide can reduce the serum PCT, TIMP-1, MMP-9, IFN-γlevels and the pulmonary arterial hypertension, improve the lung tissue oxygen supply and the cardiopulmonary function, and it was worthy clinical application.
文摘Inhaled anticholinergic agent tiotropium is widely used in the treatment of chronic obstructive pulmonary disease（COPD）. However, it has pro-arrhythmic and pro-ischaemic effects, which can potentially increase the risk of serious cardiovascular events, especially in patients with pre-existing arrhythmias. We presented a 79-year-old man with a medical history of arrhythmia, who developed atrial fibrillation after used tiotropium 18 μg daily for two weeks. We urge the caution of pro-arrhythmic effect of tiotropium. Healthcare professionals should be aware of the potential effect when prescribing tiotropium to patients with known cardiac rhythm disorders.
