Effects of salmeterol fluticasone plus tiotropium bromide on right cardiac and thyroid functions of ;patients of chronic obstructive pulmonary disease with chronic cor pulmonale
10.3760/cma.j.issn.1671-7368.2014.05.010
- VernacularTitle:沙美特罗／氟替卡松联合噻托溴铵对慢性阻塞性肺疾病患者右心功能及甲状腺功能的影响
- Author:
Dai LI
;
Hong TENG
;
Hong QIU
- Publication Type:Journal Article
- Keywords:
Drug threapy,combination;
Pulmonary disease,chronic obstractive;
Pulmonary heart disease
- From:
Chinese Journal of General Practitioners
2014;(5):361-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influence of salmeterol fluticasone plus tiotropium bromide on right cardiac and thyroid functions of patients of chronic obstructive pulmonary disease ( COPD) with chronic cor pulmonale .Methods A total of 92 cases of COPD patients with chronic cor pulmonale at our hospital from July to December 2012 were recruited as subjects and divided randomly into 2 groups of treatment ( n=47) and control (n=45).The control group received diuretics and vasodilative drugs while the treatment group had additional therapies of salmeterol fluticasone ( 50/500 μg ) twice daily plus tiotropium bromide once per day once daily for 6 months.Measure and compare two groups of patients′FEV1%, forced expiratory volume in one second(FEV1), status of vigor, brain natriuretic peptide(BNP), left ventricular ejection fraction ( LVEF ) , ultrasonic cardiogram ( right ventricular outflow tract , right ventricular internal diameter, right pulmonary artery trunk ) and value of thyroid function before and after treatment .Results Before treatment, the treatment group′s FEV1 (%) (36 ±10)%, FEV1 (1 036 ±410) ml, BNP (357 ± 101) ng/L, LVEF (46.2 ±10.4)%, internal diameter of right ventricular outflow tract (36.0 ±5.4) mm, right ventricular internal diameter (38.1 ±6.7) mm, right pulmonary artery trunk (24.0 ±3.6) mm, TT3 (1.47 ±0.38) nmol/L, TT4 (114.56 ±21.39) nmol/L, FT3 (4.47 ±1.42) pmol/L, FT4 (15.6 ± 2.5) pmol/L and TSH (2.50 ±0.91) mU/L showed no marked difference from those of control group (P>0.05).After treatment, the treatment group′s FEV1(%)(58 ±1)%, FEV1(1 706 ±456)ml, BNP(225 ± 52) ng/L, LVEF (57.1 ±11.5)%, internal diameter of right ventricular outflow tract (30.1 ±4.2) mm, right ventricular internal diameter ( 32.0 ±3.9 ) mm and right pulmonary artery trunk ( 20.2 ±2.3 ) mm greatly improved ( P <0.01 ) while its TT3 ( 1.46 ±0.42 ) nmol/L, TT4 ( 113 ±22 ) nmol/L, FT3 (4.46 ±1.38) pmol/L, FT4 (15.4 ±2.5) pmol/L and TSH (2.51 ±0.82) mU/L showed no marked difference from those of control group ( P>0.05 ) .However , no obvious difference existed in the control group′s BNP, LVEF, internal diameter of right ventricular outflow tract , right ventricular internal diameter , right pulmonary artery trunk and value of thyroid function before and after treatment ( P >0.05 ) . Conclusion Salmeterol fluticasone plus tiotropium bromide can effectively improve right cardiac functions of patients of COPD with chronic cor pulmonale , without marked suppression of thyroid function .
