小剂量阿奇霉素联合丹参川芎嗪治疗慢性阻塞性肺疾病并肺动脉高压的疗效观察

Effect of small dose Azithromycin combined with Salvia miltiorrhiza on the treatment of chronic obstructive pulmonary disease complicated with pulmonary hypertension

目的探讨小剂量阿奇霉素联合丹参川芎嗪治疗慢性阻塞性肺疾病(COPD)并肺动脉高压患者的临床疗效。方法选择COPD合并肺动脉高压患者60例,随机分为治疗组和对照组。治疗组30例在常规治疗基础上加用阿奇霉素0.125口服1次/d,联用丹参川芎嗪10 ml静滴,疗程为2周;对照组30例给予低流量吸氧,控制感染,解痉平喘、化痰、抗凝等对症治疗。两组分别测定治疗前后肺动脉压、肺功能、血气分析、6 min步行试验、内皮素-1(ET-1)、C-反应蛋白(CRP)的变化。结果治疗组总有效率80.0%,高于对照组的53.33%,差异有统计学意义(P<0.05);治疗组和对照组治疗后肺动脉压分别为29.53±3.47和34.59±3.27 mm HG,差异有统计学意义(P<0.05);两组6 min步行距离分别为138.54±10.24和122.95±10.15 m,差异有统计学意义(P<0.05);两组患者治疗后1 s用力呼气容积(FEV1)、用力肺活量(FVC)均有改善,内皮素-1、C-反应蛋白下降,治疗组变化更明显,均有统计学意义(P<0.05)。结论小剂量阿奇霉素联合丹参川芎嗪治疗COPD并肺动脉高压疗效确切,值得临床推广。

Objective To investigate the clinical effect of small dose Azithromycin combined with Danshen ligustrazine in the treatment of chronic obstructive pulmonary disease（ COPD） complicated with pulmonary hypertension. Method The 60 patients with COPD combined with pulmonary hypertension were randomly divided into two groups. The treatment group on the routine treatment plus oral azithromycin 0. 125 once daily,combined Salvia miltiorrhiza 10 ml intravenous drip,the course of 2 weeks; 30 cases of control group were treated with low flow oxygen,control infection, antispasmodic, phlegm, anticoagulation and other symptomatic treatment. The changes of pulmonary arterial pressure,pulmonaryfunction,blood gas analysis,6minutes walking test,endothelin-1（ ET-1） and C reactive protein（ CRP） were measured before and after treatment in the two groups. Result The total effective rate of the treatment group was 80. 0%,higher than that of the control group（ 53. 33%）,the difference was statistically significant（ P 0. 05）. The patients in the two groups after treatment of pulmonary artery pressure are 29. 53 ± 3. 47 and 34. 59 ± 3. 27 mm HG,the difference was statistically significant（ P 0. 05）; the patients in the two groups after treatment of 6 minutes walk distance are 138. 54 ± 10. 24 and 122. 95 ± 10. 15 m,the difference was statistically significant（ P 0. 05）; The patients in the two groups after treatment of FEV1,FVC were improved,ET-1 and CRP decreased,were more obvious in the treatment group,the difference was statistically significant（ P 0. 05）. Conclusion Small dose Azithromycin combined with Danshen ligustrazine is safe and effective in treating hypertension in patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension. It is worthy of clinical application.