辛伐他汀联合法舒地尔治疗COPD合并肺动脉高压患者临床效果观察

Clinical effect observation of simvastatin combined with fasudil hydrochloride on treatment of patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension

目的观察辛伐他汀联合法舒地尔治疗慢性阻塞性肺病(COPD)合并肺动脉高压患者的临床效果。方法将我院接受治疗的72例慢性阻塞性肺病合并肺动脉高压患者采用随机数字法将其分为观察组和对照组各36例。对照组患者给予抗炎、平喘、化痰等常规治疗,观察组患者给予辛伐他汀联合法舒地尔治疗,并观察比较两组患者的治疗效果以及治疗前后PH(动脉血)、PaCO2(动脉血二氧化碳分压)、PaO2(动脉肺泡氧分压)、PaO2/FiO2等指标以及血浆细胞因子白介素-1(IL-1)、白介素-6(IL-6)、内皮素-1(ET-1)和肺功能变化FEV1(一秒用力呼吸容积)、FEC水平(用力肺活量)等指标改善情况。结果观察组的总有效率为97.22%,明显高于对照组的75%(P<0.05)。治疗前两组患者的PH、PaCO2、PaO2、PaO2/FiO2等指标差异无统计学意义(均P>0.05);治疗后观察组患者各项指标均明显优于对照组患者(t=3.210、4.644、2.636、2.925,均P<0.05);观察组患者IL-1、IL-6及ET-1均明显低于对照组(t=3.986、2.4052、3.418,均P<0.05),且相比治疗前降低更为显著;观察组患者肺功能变化FEV1、FEC水平均优于对照组(P<0.05)。结论辛伐他汀联合法舒地尔对慢性阻塞性肺病合并肺动脉高压患者具有显著的临床疗效,值得临床推广。

Objective To explore the clinical effect of simvastatin combined with fasudil hydrochloride in the treatment of patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension.Methods 72 patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension treated in our hospital were randomly divided into observation group and control group with 36 cases in control group.The control group was given the routine treatment of anti inflammation,relieving asthma,eliminating phlegm.The observation group was given simvastatin combined with fasudil treatment.The therapeutic effect,the improvement of pH（arterial blood）PaCO2（partial pressure of arterial carbon dioxide）,PaO2（Alveolar arterial oxygen partial pressure）,PaO2/FiO2 indexes,plasma cytokines interleukin 1（IL-1）and interleukin 6（IL-6）,endothelial endothelin-1（ET-1）and pulmonary function changes in FEV1（one second forced expiratory volume）,FEC level（forced vital capacity）and other indicators before and after treatment of patients in the two groups were observed.Results The total effective rate of the observation group（97.22%）was significantly higher than that of control group（75%）（P〈0.05）.There were no significant differences in PaCO2,PaO2,PaO2/FiO2 and PH levels between the two groups before treatment（P〉0.05）,that of the observation group were significantly better than those in the control group after treatment（t=3.210,4.644,2.636,2.925,all P〈0.05）.IL-1,IL-6and ET-1levels in the observation group were significantly lower than those in the control group（t=3.986,2.4052,3.418,all P〈0.05）,that of the decreased degrees was more significant than that of the control group.The changes of lung function FEC and FEV1 levels in the observation group were better than those in control group（P〈0.05）.Conclusion Simvastatin combined with fasudil hydrochloride on chronic obstructive pulmonary disease complicatedwith pulmonary artery hypertension has significant clinical efficacy.