辛伐他汀联合运动训练治疗COPD稳定期合并代谢综合征患者的临床研究

Clinical Reseach of Simvastatin Combined with Exercise Training in Treatment of Patients with Stable COPD and Metabolism Syndrome

目的:探讨辛伐他汀联合运动训练治疗慢性阻塞性肺疾病(COPD)稳定期合并代谢综合征患者的临床疗效,为临床治疗提供指导。方法:按照随机数字表法将2013年9月-2015年3月我院收治的COPD稳定期合并代谢综合征患者分为A、B组和对照组,A组患者在常规治疗的基础上联合辛伐他汀和运行训练,B组患者在常规治疗的基础上以辛伐他汀治疗,对照组患者仅以常规治疗。治疗后6个月,比较三组患者的临床治疗效果。结果:A、B组治疗后的血清白细胞介素-6(IL-6)白细胞介素-8(IL-8)以及肿瘤坏死因子-α(TNF-α)水平低于治疗前,差异有统计学意义(P<0.05),对照组治疗后的IL-6、IL-8及TNF-α水平与治疗前差异无统计学意义(P>0.05),治疗后A组的IL-6、IL-8及TNF-α水平明显低于B组,差异有统计学意义(P<0.05)。A组的胰岛素抵抗指数(HOMA-IR)低于B组、对照组,差异有统计学意义(P<0.05);A、B组的颈-股动脉脉搏波速度(CFPWV)低于对照组,差异有统计学意义(P<0.05)。A、B组治疗后的改良医学研究委员会量表(m MRC)低于对照组,A组m MCR低于B组,差异有统计学意义(P<0.05),A、B组治疗后的6 min步行距离(6MWD)高于对照组,A组6MWD高于B组,差异有统计学意义(P<0.05)。结论:辛伐他汀联合运动训练能明显降低COPD稳定期合并代谢综合征患者的炎症性反应,改善患者的胰岛素抵抗和大动脉弹性,提高临床治疗效果。

Objective： To explore the clinical efficacy of simvastatin combined with exercise training in treatment of patients with stable chronic obstructive pulmonary disease（COPD） and metabolism syndrome, and to provide guidance for clinical treatment. Methods：The patients with stable COPD and metabolic syndrome in our hospital from September 2013 to March 2015 were divided into A group,B group and control group by the random number table method, A group was treated with simvastatin combined with exercise training on the basis of conventional treatment, B group was treated with simvastatin on the basis of conventional treatment, and control group was only treated with conventional treatment. After 6 months of treatment, compared the clinical efficacy of three groups. Results： The levels of serum interleukin-6（IL-6）, interleukin-8（IL-8） and tumor necrosis factor-α（TNF-α） of A, B group after treatment were lower than before treatment, the differences were statistically significant（P〈0.05）. There were no significant on the levels of serum IL-6, IL-8 and TNF-α of control group before and after treatment（P〉0.05）. The levels of serum IL-6, IL-8 and TNF-α of A group were significantly lower than B group after treatment, the differences were statistically significant（P〈0.05）. The homeostasis model assessment of insulin resistance（HOMA-IR） of A group was lower than B group and control group, the differences were statistically significant（P〈0.05）; The C-F pulse wave velovity（C-FPWV） of A group and B group were lower than control group, the differences were statistically significant（P〈0.05）.The modified medical research council scale（m MCR） of A group and B group were lower than control group, and the A group was lower than B group after treatment, the differences were statistically significant（P〈0.05）. The 6 minutes walking distance（6MWD） of A group and B group were higher than control group, while the A group was higher than B group after treatment, the differences were statistically significant（P〈0.05）. Conclusion： Simvastatin combined with exercise training can significantly reduce the inflammatory response in patients with stable COPD and metabolic syndrome, improve the insulin resistance and large arterial elasticity of patient, and improve clinical efficacy.