阿托伐他汀治疗稳定期重度COPD的临床研究

Clinical research about the atovastatin treatment effect on stable stage of severe chronic obstructive pulmonary disease

目的观察阿托伐他汀对稳定期重度COPD患者肺功能、平均肺动脉压(mPAP)、生命质量和年住院次数的影响。方法 40例稳定期重度COPD患者按随机数字表法分为两组:A组(常规治疗组)20例(男16例,女4例),常规吸入β2受体激动剂、糖皮质激素及抗胆碱能药物,不能接受吸入治疗者口服茶碱类药物或β2受体受体激动剂,服用祛痰药物,血氧饱和度<90%者行家庭氧疗;B组(阿托伐他汀组)20例(男15例,女5例)在常规治疗的基础上加用阿托伐他汀20 mg,每晚睡前服用。结果两组患者FEV1均下降,而A组下降更迅速。A组6 min步行测验(6MWT)逐渐下降;mPAP逐渐上升;圣乔治呼吸问卷评分上升;因急性加重住院次数增加。而B组上述指标较治疗前均有改善。两组各项指标比较差异均有统计学意义。结论阿托伐他汀可减缓重度COPD患者肺功能下降速度、改善肺动脉高压及生命质量、减少急性加重次数。

Objective To observe the effect on pulmonary function,mean pulmonary artery pressure（mPAP）,quality of life and the number of hospitalization per year by using atovastatin in the stable stage patients with severe chronic obstructive pulmonary disease（COPD）.Method 40 cases with stable severe COPD patients were randomly divided into two groups：A group（aonventional treatment group）,20 patients（16 males,4 females）,conventional inhaled β2 agonists,corticosteroids and anti-cholinergic drugs.Patients who can not accept inhalation therapy were treated with oral theophylline drugs or β2-receptor agonists,expectorant drugs and home oxygen therapy if oxygen saturation 90%;B group（atorvastatin group）,20 patients（15 males,5 females）,besides conventional treatment,20mg atorvastatin was used every night at bedtime.Results FEV1 of two groups of patients were decreased,while the A group decreased more rapidly.In A group,6min walk test（6MWT） decreased gradually;mPAP increased gradually;SGRQ（St george＇s respiratory questionnaire） score increased;frequency of hospitalization due to acute exacerbation increased.In B group,these indicators were improved compared with before treatment.The indicators of the two groups were significantly different.Conclusion Atorvastatin can slow down the rate of pulmonary function decline,improve pulmonary hypertension and quality of life and reduce the frequency of acute exacerbations in patients with severe COPD.