阿奇霉素对于稳定期慢性阻塞性肺疾病患者下呼吸道细菌定植的影响

The influence of azithromycin on lower airway bacterial colonization in stable phase of chromc obstructive pulmonary disease

目的探讨阿奇霉素对慢性阻塞性肺疾病(COPD)稳定期患者下呼吸道细菌定植(LABC)的影响。方法将确诊为中、重度COPD患者分为阿奇霉素治疗组37例和对照组39例,治疗组予阿奇霉素片0.5g,每日1次,每周3次口服;对照组为稳定期未用药患者,两组患者均在稳定期入组时及1年后进行下呼吸道诱导痰细菌学检查。比较两组患者1年后LABC变化情况、年平均急性加重次数和急性加重的间隔时间。结果两组患者的下呼吸道定植菌主要为肺炎链球菌、流感嗜血杆菌、卡他莫拉菌,治疗组在治疗后LABC发生率为13.5%,较对照组30.7%显著降低;治疗组在治疗后急性加重次数为(1.35±1.10)次,较对照组急性加重次数(2.98±1.59)次明显减少;治疗组在治疗后急性加重的时间间隔为(271.54±71.33)天,较对照组间隔时间(191.28±54.12)天明显延长。结论中、重度COPD稳定期患者LABC发生率增高,是导致COPD急性加重的重要因素。阿奇霉素对于COPD患者防止病情急性加重具有积极的意义。

Objective The aim of this study was to determine the influence of intermittent azithromyein therapy on the frequency of exacerbation and lower airway bacterial colonization （LABC） in stable phase of chronic obstructive puhnonary disease （COPD）. Method Will be diagnosed in moderate to severe COPD patients were divided into azithromycin in the treatment group and the control group, the azithromycin treatment group received azithromycin tab-lets 0.5 g / day, 3 times a week orally; patients with untreated control group for the stabilization period, patients in both groupsThe induced sputum bacteriological examination of the lower respiratory tract into the group of the stabilization period and 1 year after. LABC changes after one year of the two groups were compared, the average annual number of acute exacerbation and acute exacerbation interval. Result 76 patients who completed the 12-month treat- ment period were analyzed. No clinically significant adverse events were observed during azithromycin treatment. Compared with baseline data, azithromycin therapy significantly reduced the number of AECOPD （1. 35±1. 10versus 2.98±1.59）. The time to the first exacerbation was （271.54±71.33） days among participants receiving azithromycin, as compared with （191.28±54.12）days among participants receiving placebo. Conclusion Longterm azithromycin is well tolerated and associated with significant reductions in AECOPD, hospitalizations, and length of hosp;tal stay in patients with severe COPD.