Effect of Tiotropium Bromide on Airway Remodeling and JAK/STAT Pathway Protein in Patients with Acute Exacerbation of COPD with Pul-monary Infection
To study the effects of tiotropium bromide on airway remodeling and Janus kinase(JAK)/signal transducer and activator of transcription(STAT)pathway protein in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD),from January 2022 to January 2023,268 patients with acute exacerbation of COPD pulmonary infection admitted to the hospital were divided into a conventional group(134 cases)receiving conventional treatment and a combination of tiotropium bromide group(134 cases)receiving treatment with tiotropium bromide.The grouping method was random drawing,and both groups were treated for 1 month.The clinical efficacy after 1 month of treatment,symptom disappearance time and adverse reactions of the two groups were counted,and the JAK/STAT pathway protein,inflammation index,infection severity,immune function,blood gas index and airway remodeling index were compared between the two groups before and after 1 month of treatment.After 1 month of treatment,the total effective rate of the tiotropium bromide group was higher than that of the conventional group(P＜0.05).The disappearance time of cough,fever and lung rales in the tiotropium bromide group was shorter than that in the conventional group(P＜0.05).After 1 month of treat-ment,levels of serum Janus kinase 1(JAK1),signal transduction and transcription activating factor 1(STAT1),Janus kinase 2(JAK2),signal transduction and transcription activating factor 2(STAT2),procalcitonin(PCT),and tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),soluble intercellular adhesion molecule-1(sICAM-1),hypersensitive C-reactive protein(hs-CRP),peripheral blood leukocytes(WBC),peripheral blood CD8+,score of clinical pulmonary infection score(CPIS),partial pressure of carbon dioxide(PaCO2),tracheal wall thickness to outer diameter ratio(T/D),and airway wall area to total cross-sectional area ratio(WA)in the two groups decreased compared to before treatment,and the tiotropium bromide group was lower than the conven-tional group(P＜0.05).The levels of peripheral blood CD3+,CD4+,CD4+/CD8+,oxygenation index,and partial pressure of oxygen(PaO2)increased compared to before treatment,and the tiotropium bromide group was higher than the conventional group(P＜0.05).During the treatment period,there was no statistically significant difference in the total incidence of adverse reactions between the tiotropium bromide group and the conventional group(P＞0.05).Tiotropium bromide could regulate the protein level of JAK/STAT pathway in COPD patients with acute exacerbation of pulmonary infection,reduce their inflammatory reaction,improve their immune function and blood gas index,and relieve their airway remodeling,which was helpful to promote the disappearance of clinical symptoms,with good therapeutic effect and good safety.
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