辛伐他丁联合阿司匹林对稳定期慢性阻塞性肺疾病肺功能及肺动脉高压的影响

Effect of Simvastatin in Combination with Aspirin on Lung Function and Ppulmonary Arterial Hypertension in Stable Chronic Obstructive Pulmonary Disease

目的观察辛伐他丁联合阿司匹林片治疗对稳定期慢性阻塞性肺疾病合并相关肺动脉高压的疗效。方法选取确诊慢性阻塞性肺疾病合并肺动脉高压的门诊及住院病人200例,随机分对照组(Ⅰ组)50例、阿司匹林(Ⅱ组)50例、辛伐他丁组(Ⅲ组)50例、辛伐他丁联合阿司匹林(Ⅳ组)50例,对照组给予常规氧疗、平喘、抗炎治疗,阿司匹林组常规治疗外加用100mg qd治疗,辛伐他丁组常规治疗外加用40mg qn治疗,辛伐他丁联合阿司匹林组常规治疗外加用辛伐他丁40mg qd、阿司匹林100mg qd,同时对照组加用安慰剂。观察各组治疗前后(疗程2月)肺功能(FEV1、FEVI/FVC%)、肺动脉收缩压及平均肺动脉压(mPAP)的变化情况。结论辛伐他丁组及辛伐他丁联合阿司匹林组治疗后患者平均肺动脉压明显降低,与治疗前及对照组比较差异有统计学意义(P<0.05),与单独使用相比,联合应用对改善肺动脉高压更明显;二组肺功能下降较对照组更缓慢(P<0.05)。

Objective To investigate the treatment effect of simvastatin combined with aspirin in stable chronic obstructive pulmonary disease（COPD）with pulmonary arterial hypertension （PAH）.Methods 200 cases with chronic obstructive pulmonary disease with pulmonary arterial hypertension outpatients and inpatients were collected, which were randomly divided into control group （groupⅠ, 50 cases）, aspirin group（groupⅡ, 50 cases）, simvastatin group （groupⅢ, 50 cases） and simvastatin in combination with aspirin group（groupⅣ, 50 cases）. Patients in the control group received conventional oxygen therapy, relieving asthma and anti-inflammatory treatment; Patients in the aspirin group received aspirin therapy with 100mg qd plus conventional therapy; Patients in the simvastatin group received simvastatin therapy with 40mg qn plus conventional treatment; Patients in the simvastatin in combination with aspirin group received simvastatin combined with aspirin with simvastatin 40mg qd and aspirin 100mg qd plus conventional therapy. The control group received placebo.The lung function （FEV1, FEVI/FVC%）, pulmonary artery systolic and mean pulmonary arterial pressure （mPAP） changes in each group before and after treatment before （2 months course of treatment） were investigated. Conclusion The mean pulmonary arterial pressure in simvastatin group and simvastatin in combination with aspirin group was significantly reduced after treatment, and the difference was statistically significant （P〈0.05） compared with the control group and the same group before the treatment. Compared to using one kind of the two drugs, the combination of the two drugs could improve pulmonary hypertension obviously. Simvastatin group and simvastatin combined with aspirin group could reduce lung function more slowly than the control group （P〈0.05）.