Effect of Smoking on ICS/LABA Therapy for Elderly Patients with COPD
- VernacularTitle:吸烟对老年慢性阻塞性肺疾病患者ICS／LABA 治疗疗效的影响
- Author:
Juan XIE
1
;
Ying ZHANG
;
Shan NG ZHA
;
Dong Jin SHI
Author Information
1. 复旦大学附属上海市第五人民医院老年科
- Keywords:
Chronic obstructive pulmonary disease;
Smoking;
Inhaled corticosteroids;
Long-acting beta-2 agonists
- From:
Chinese Journal of Clinical Medicine
2016;23(1):34-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the effect of smoking on inhaled corticosteroids and long‐acting beta‐2 agonists (ICS/LABA) therapy for patients with moderate to severe chronic obstructive pulmonary disease (COPD) .Methods:Elderly patients with moderate to severe COPD in stable stage ,who consulted doctors at Department of Geriatric Respiratory Disease in our hospital or were admitted to our hospital during January 2013 and December 2013 ,were selected and allocated to smoking group (n=98) or ex‐smoker group(n=98) .All subjects were treated with inhaled formoterol and budesonide ,and the treatment lasted for 6 months .Before treatment and at the 3rd and 6th month of treatment ,pulmonary function (FEV1 pred% ,FEV1/FVC % ) , concentration of interleukin‐8(IL‐8) and tumor necrosis factor‐α(TNF‐α) in the blood ,and glucocorticoid receptor (GR)‐αand GR‐βpositive peripheral blood mononuclear cells (PBMC) were determined ,and meanwhile dyspnea score was evaluated . Results:In both smoking group and ex‐smoker group ,compared with that before treatment ,at the 3rd and 6th month of treatment ,the FEV1% and FEV1/FVC% gradually increased (P< 0 .05) ,dyspnea score decreased (P< 0 .05) .Blood concentrations of TNF‐α and IL‐8 decreased gradually after treatment (P< 0 .05) .The percentage of GR‐α positive PBMC didn’t change significantly (P>0 .05) ,while the percentage of GR‐βpositive PBMC decreased significantly at the 6th month of treatment in ex‐smoker group (P<0 .05) .Compared with that in smoking group ,FEV1% and FEV1/FVC% in ex‐smoker group increased more at the 3rd and 6th month of treatment ,while dyspnea score declined more (P< 0 .05) ,as well as the TNF‐αand IL‐8 (P< 0 .05) .At the 3rd and 6th month of treatment ,GR‐α positive PBMCs increased more in ex‐smoker group ,while GR‐βpositive PBMCs decreased more (P<0 .05) .Conclusions :For both smokers and ex‐smokers with CODP , ICS/LABA can improve pulmonary function , relieve respiratory symptoms , reduce inflammatory reaction , and regulate glucocorticoid receptor .Smoking has negative effect on ICS/LABA treatment .
