Effect of Spirva combined with Symbicort in treatment of chronic obstructive pulmonary disease patients complicated with pulmonary heart disease

Objective To explore the efficacy of Tiotropium Bromide Powder Inhalant (Spirva) combined with Budesonide/Formoterol Powder Inhalant (Symbicort) in the treatment of chronic obstructive pulmonary disease (COPD) patients complicated with pulmonary heart disease.

Methods A total of 106 COPD patients complicated with pulmonary heart disease were selected and randomly divided into control group and observation group, with 53 cases in each group. The control group was treated with Spirva, while the observation group was treated with Spirva and Symbicort. After 3 courses of treatment, the clinical efficacy, pulmonary function indicatorsforced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), peak expiratory flow (PEF), total lung capacity (TLC), pulmonary artery pressure indicatorspulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), mean pulmonary artery pressure (MPAP), inflammatory factorspulmonary surfactant protein A (SP-A), pulmonary-activating regulated chemokine (PARC), Toll-like receptor 2 (TLR2) and therapeutic safety of the patients were evaluated.

Results The total effective rate was 90.57% in the observation group, which was significantly higher than 73.58% in the control group (P < 0.05). After treatment, levels of FVC, FEV₁, PEF and TLC increased significantly in both groups, and the levels of FVC, FEV₁, PEF and TLC in the observation group were significantly higher than those in the control group (P < 0.05). After treatment, the levels of PASP, PADP and MPAP in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of inflammatory factors in both groups decreased significantly, and the levels of SP-A, PARC and TLR2 in the observation group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions in the observation group and the control group were 15.09% (8/53) and 11.32% (6/53) respectively, which showed no significant difference between two groups (P>0.05).

Conclusion Spirva combined with Symbicort is effective in the treatment of COPD patients complicated with pulmonary heart disease, which can improve lung function, reduce pulmonary artery pressure, suppress the expression of inflammatory factors, and the safety is good.