辛伐他汀治疗稳定期慢性阻塞性肺病合并肺动脉高压的临床疗效观察

Clinical Observation of Simvastatin Treatment of Stable COPD Patients with PH

目的:探讨辛伐他汀对稳定期慢性阻塞性肺病(COPD)合并肺动脉高压(PH)患者肺动脉压、动脉血气、肺功能以及运动耐力的改善作用。方法:选择稳定期COPD合并PH患者68例,随机分为治疗组36例和对照组32例,两组患者均按COPD稳定期常规治疗,治疗组加用辛伐他汀40mg口服1次/睡前,对照组每日口服硝苯地平控释片30mg口服1次/d,比较治疗6个月后两组间肺动脉压、动脉血气、肺功能及运动耐力变化。结果:治疗6个月后,两组肺动脉压(mPAP)、血气分析、肺功能、运动耐量均较前明显改善(P<0.05),治疗组治疗6个月后肺动脉压较对照组降低更显著(P<0.05);治疗组治疗6个月后动脉血气较对照组改善明显(P<0.05);治疗组肺功能改善较对照组更明显(P<0.05),治疗组治疗6个月后运动耐力较对照组改善明显(P<0.05)。结论:辛伐他汀治疗COPD合并PH,能降低肺动脉压及动脉血二氧化碳分压(PaCO2),提高氧分压(PaO2),改善运动耐量及肺功能,且优于硝苯地平控释片。

Objective ：To observe the improvement of mPAP ,arterial blood gas （ABG） ,lung function ,exercise toler‐ance of simvastatin treatment of stable COPD （chronic obstructive pulmonary disease） patients with PH （pulmonary hypertension） .Methods ：68 subjects with stable COPD with PH were randomly divided into a treatment group （n= 36） and a control group （n= 32） .Two groups were treated with conventional therapy of stable COPD ,but the treatment group was treated with simvastatin （40mg po hs） and the control group was treated with Nifedipine Controlled Release Tablets （30mg po qd） .To compare the different of mPAP ,arterial blood gas （ABG） ,lung function ,exercise tolerance between prior and 6 months treatment .Results ：6 months after the treatment respectively ,there were improvements of mPAP ,arterial blood gas （ABG） ,lung function ,exercise tolerance in both groups than before treatment （P〈 0 .05） .In the control group ,mPAP ,arterial blood gas （ABG） ,lung function ,exercise tolerance 6 months after treatment were higher than those before treatment （P〈 0 .05） .Conclusion ：Simvastatin treatment of stable COPD with PH ,can reduce pulmonary arterial hypertension and PaCO2 ,increase PaO2 ,improve exercise tolerance and lung function ,and is better than Nifedipine Controlled Release Tablets .