The Therapeutic effect of Tiotropium on Patients with Chronic Obstructive Pulmonary Disease of Different Phenotypes_West China Medical Journal

Authors：

LI Jiqiong

Department of Respiratory Medicine, the Second People’s Hospital, Chengdu, Sichuan 610017, P. R. China;

Corresponding author：

Keywords：

慢性阻塞性肺疾病; 肺功能; 运动耐量; 噻托溴铵

DOI：

10.7507/1002-0179.20130056

Video：

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目的　评价噻托溴铵对不同表型慢性阻塞性肺疾病（COPD）患者的疗效。方法　选取2008年10月－2010年5月COPD患者81例，根据胸部高分辨率CT上的形态表现分型，以气道病变为主型纳入A组，以肺气肿为主型纳入B组，按方案吸入噻托溴铵，在给药前后分别测定肺功能、圣?乔治呼吸问卷评分（SGRQ）及6 min步行距离。结果　用药3个月后A组的第1秒用力肺活量（FEV1）、用力肺活量（FVC）、FEV1/FVC及FEV1占预计值（%）比B组明显提高，两组比较差异有统计学意义（P＜0.05），SGRQ评分比较B组明显下降，运动耐力（6 min步行距离）增加（P＜0.05）。结论　噻托溴铵在COPD的治疗中，针对不同的表型，其疗效不同。

Citation： LI Jiqiong. The Therapeutic effect of Tiotropium on Patients with Chronic Obstructive Pulmonary Disease of Different Phenotypes. West China Medical Journal, 2013, 28(2): 172-174. doi: 10.7507/1002-0179.20130056 Copy

1.	Makita H, Nasuhara Y, Nagai K, et al. Characterization of phenotypes based on severity of emphysema in chronic obstruction pulmonary disease[J]. Thorax, 2007, 62(11): 932-937.
2.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组．慢性阻塞性肺疾病诊治指南(2007年修订版)[J]．中华结核和呼吸杂志, 2007, 30(1): 8-17．.
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4.	Matsuoka S, Yamashiro T, Washko GR, et al. Quantitative CT assessment of chronic obstructive pulmonary disease[J]. Radiographics, 2010, 30(1): 55-66．.
5.	Tatsumi K, Kasahana Y, Kurosu K,et al. Clinical phenotypes of COPD：resulys of a Japanses epidemioligie survey[J]. Respiralogy, 2004, 9(3): 331-336.
6.	程艳慧, 何东初. COPD发病机制分子生物学的最新研究进展[J]. 临床肺科杂志, 2010, 15(2): 232-233.
7.	Fujimoto K, Kitaguchi Y, Kubo K, et al. Clinical analysis of chronicobstructive pulmonary disease phenotypes classified using highresolution computed tomography[J]．Respirology, 2006, 11(6): 731-740．.
8.	Nakono Y, Muro S, Sakai H, et al. Computed tomographic measurement of airway dimenstions and emphysema in smokers：correlation with lung function[J]．Am J Respir Crit Care Med, 2000, 162(3 Pt 1): 1102-1108．.
9.	Casaburi R, Kukafka D, Cooper CB, et al. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD[J]. Chest, 2005, 127(3): 809-817．.
10.	Barnes PJ, Stockley RA. COPD: current therapeutic interventions and future approaches[J]. Eur Respir, 2005, 25(6): 1084-1106．.
11.	Casaburi R, Mahler DA, Jones PW, et al. A Long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease[J]．Eur Respir J, 2002, 19(2): 217-224．.
12.	Tashkin DP, Celli B, Senn S, et al. A 4-Year Trial of Tiotropium in Chronic Obstructive Pulmonary Disease[J]. N Engl J Med, 2008, 359(15): 1543-1554．.
13.	王长征．药物治疗能改变慢性阻塞性肺疾病患者肺功能的下降速率吗? [J]. 中国呼吸与危重监护杂志, 2009, 8(1): l-2．.
14.	Saito Y, Azuma A, Morimoto T, et al. Tiotropium ameliorates symptoms in patients with chronic airway mucus hypersecretion which is resistant to Macrolide therapy[J]. Intern Med, 2008, 47(7): 585-591．.
15.	Profita M, Bonanno A, Siena L, et al. Acetylcholine mediates the release of IL-8 in human bronchial cells by a NFκB/ERK-dependent mechanism[J]. Eur J Pharmacol, 2008, 582(1-3): 145-l53．.
16.	Bühling F, Lieder N, Kuhlmann UC, et al. Tiotropium suppresses acetylcholine-induced release of chemotactic mediators in vitro[J]. Respir Med, 2007, l01(11): 2386-2394．.

1. 　Makita H, Nasuhara Y, Nagai K, et al. Characterization of phenotypes based on severity of emphysema in chronic obstruction pulmonary disease[J]. Thorax, 2007, 62(11): 932-937.
2. 　中华医学会呼吸病学分会慢性阻塞性肺疾病学组．慢性阻塞性肺疾病诊治指南(2007年修订版)[J]．中华结核和呼吸杂志, 2007, 30(1): 8-17．.
3. 　Celli BR, Roger S. Mitchell lecture. Chronic obstructive pulmonary disease phenotype and their clinic relevance[J]. Proc Am Thorac Soc, 2006, 3(6): 461-465．.
4. 　Matsuoka S, Yamashiro T, Washko GR, et al. Quantitative CT assessment of chronic obstructive pulmonary disease[J]. Radiographics, 2010, 30(1): 55-66．.
5. 　Tatsumi K, Kasahana Y, Kurosu K,et al. Clinical phenotypes of COPD：resulys of a Japanses epidemioligie survey[J]. Respiralogy, 2004, 9(3): 331-336.
6. 　程艳慧, 何东初. COPD发病机制分子生物学的最新研究进展[J]. 临床肺科杂志, 2010, 15(2): 232-233.
7. 　Fujimoto K, Kitaguchi Y, Kubo K, et al. Clinical analysis of chronicobstructive pulmonary disease phenotypes classified using highresolution computed tomography[J]．Respirology, 2006, 11(6): 731-740．.
8. 　Nakono Y, Muro S, Sakai H, et al. Computed tomographic measurement of airway dimenstions and emphysema in smokers：correlation with lung function[J]．Am J Respir Crit Care Med, 2000, 162(3 Pt 1): 1102-1108．.
9. 　Casaburi R, Kukafka D, Cooper CB, et al. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD[J]. Chest, 2005, 127(3): 809-817．.
10. 　Barnes PJ, Stockley RA. COPD: current therapeutic interventions and future approaches[J]. Eur Respir, 2005, 25(6): 1084-1106．.
11. 　Casaburi R, Mahler DA, Jones PW, et al. A Long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease[J]．Eur Respir J, 2002, 19(2): 217-224．.
12. 　Tashkin DP, Celli B, Senn S, et al. A 4-Year Trial of Tiotropium in Chronic Obstructive Pulmonary Disease[J]. N Engl J Med, 2008, 359(15): 1543-1554．.
13. 　王长征．药物治疗能改变慢性阻塞性肺疾病患者肺功能的下降速率吗? [J]. 中国呼吸与危重监护杂志, 2009, 8(1): l-2．.
14. 　Saito Y, Azuma A, Morimoto T, et al. Tiotropium ameliorates symptoms in patients with chronic airway mucus hypersecretion which is resistant to Macrolide therapy[J]. Intern Med, 2008, 47(7): 585-591．.
15. 　Profita M, Bonanno A, Siena L, et al. Acetylcholine mediates the release of IL-8 in human bronchial cells by a NFκB/ERK-dependent mechanism[J]. Eur J Pharmacol, 2008, 582(1-3): 145-l53．.
16. 　Bühling F, Lieder N, Kuhlmann UC, et al. Tiotropium suppresses acetylcholine-induced release of chemotactic mediators in vitro[J]. Respir Med, 2007, l01(11): 2386-2394．.

West China Medical Journal

The Therapeutic effect of Tiotropium on Patients with Chronic Obstructive Pulmonary Disease of Different Phenotypes

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