罗红霉素治疗慢性阻塞性肺疾病稳定期患者气道炎症疗效观察

Effect of Roxithromycin on Airway Inflammation in Patients with Chronic Obstructive Pulmonary Disease at Stable Phase

目的:观察罗红霉素对慢性阻塞性肺疾病(COPD)稳定期患者气道炎症的疗效,为COPD稳定期治疗提供依据。方法:COPD稳定期门诊患者46例分为观察组和对照组。对照组给予常规治疗,观察组在对照组基础上加用罗红霉素软胶囊150 mg·d-1,均治疗10个月。比较两组患者痰液和血清中γ-IFN、IL-8和TNF-α等细胞因子水平,以及痰液中白细胞、中性粒细胞计数的变化,观察两组药品不良反应发生情况。结果:用药5个月时,观察组患者血清和痰液中的γ-IFN、IL-8和TNF-α等细胞因子水平均较用药前明显下降(P<0.05),痰中白细胞、中性粒细胞计数较用药前明显下降(P<0.05),且上述指标均明显低于对照组(P<0.05);用药10个月时,观察组患者上述指标较用药5个月时又有明显下降(P<0.05),且均显著低于对照组(P<0.05)。观察组仅发生1例药品不良反应,患者退出研究。结论:长期服用小剂量罗红霉素可以降低COPD稳定期患者痰液和血清中的细胞因子,以及痰液中炎症细胞计数,对气道炎症有一定的抑制作用。

Objective：To investigate the effect of roxithromycin on airway inflammation in chronic obstructive pulmonary disease （ COPD） patients at stable phase to provide evidence for the clinical diagnosis and treatment .Methods：Totally 46 cases of outpatients with stable COPD were divided into the observation group and the control group .The control group received the conventional treatment , while the observation group was treated with roxithromycin capsules 150mg.d-1 additionally, and the treatment course was 10 months. The sputum, serum cytokines γ-IFN, IL-8 and TNF-αlevels, sputum leukocyte , neutrophil count and adverse reactions were observed and compared between the groups .Results：After the 5-month treatment, the levels of γ-IFN, IL-8 and TNF-αcytokines in serum and sputum in the observation group were significantly lower than those before the treatment （P〈0.05） and in the control group （P〈0.05）.After the 10-month treatment, the above indices in the observation were further decreased when compared with those after the 5-month treatment （P〈0.05）, which were notably lower than those in the control group （P〈0.05）.There was only one case of ad-verse drug reactions in the observation group , and the patient was out of the study .Conclusion：Long-term use of roxithromycin at low dose can reduce cytokines in serum and sputum and inflammatory cell count in sputum in stable COPD patients , which exhibits the effect on airway inflammation to some extent .