Effects of fluticasone propionate/salmeterol and tiotropium on arterial elastic function of patients with moderate to severe chronic obstruction pulmonary disease

Abstract:

Objective：To explore the effects of fluticasone propionate/salmsalmeterol（FSC）and tiotropium on arterial stiffness in pa－tients with stable chronic obstruction pulmonary disease（COPD）. Methods：All 136 patients with stable COPD were randomly divided into three groups：FSC group（group F，n=45），tiotropium group（group T，n=45） and blank control group（group B，n=46）. Patients in group B received the conventional therapy while those in group F FSC per day for 12 weeks and those in group T inhaled tiotropium per day for 12 weeks. Changes in brachial-angle pulse wave velocity（baPWV），large and small arterial compliance（C1 and C2），augementation index（AI），high sensitive C-reactive protein（hsCRP） were observed. Results：①Multiple stepwise regression analysis demonstrated that body mass index（P=0.000），course of disease（P=0.000），hsCRP（P=0.000） and smoking index（P=0.002） were pos－itively associated with baPWV while the forced expiratory volumein one second（FEV1）（P=0.000） was negatively associated with baPWV. ②At 12 weeks after the treatment，hsCRP and C1，C2 were improved compared with those before the treatment（P＜0.01），more obviously in group F（P＜0.05）. Significant differences presented in the above indexes in comparison between group F，group T and group B after the treatment（P＜0.05）. The arterial elastic paramenters of group B and AI of group F and group T were not sig－nificantly improved（P ＞0.05）. ③baPWV of group F and group T was decreased along with the time，more obvious in group F and most significantly in group c（baPWV＞21.21 m/s） among subgroups of group F. No decrease of baPWV was observed in group B. Conclusion：Fluticasone propionate/salmsalmeterol had broader impacts on arterial stiffness of patients with COPD compared with tiotropium.