小剂量红霉素长期口服对支气管扩张症患者感染稳定期链球菌耐药性和氧化应激蛋白的影响

The effect of long-term low-dose oral erythromycin on streptococcusresistance and oxidative stress proteins for patients with stable bronchiectasis

目的观察长期口服小剂量红霉素对支气管扩张症稳定期患者的临床疗效及其对链球菌耐药性、氧化应激蛋白的影响。方法 104例支气管扩张症稳定期患者随机分为两组,治疗组口服红霉素,对照组口服安慰剂。6个月后,比较两组患者的胸部CT影像评分、口咽部优势菌的耐药率、外周血单个核细胞(PBMC)中ROS量及血清SOD活性。结果治疗后治疗组胸部CT影像各项目评分与治疗前及对照组相比得到显著改善,差异有统计学意义(P<0.05)。治疗组链球菌对红霉素耐药率34.62%显著高于对照组9.62%;治疗组PBMC中的ROS倍增数显著低于对照组,同时其SOD值显著高于对照组,差异有统计学意义(P<0.05)。结论长期小剂量服用红霉素改善支气管扩张稳定期患者的胸部CT影像评分,降低氧化应激蛋白含量,改善血清ROS及SOD含量,有较好的临床疗效,但能在一定程度上提高病菌对大环内酯类药物的耐受性。

Objective To observe the clinical efficacy of patients with stable bronchiectasis infection and the effect on bacterial resistance and oxidative stress proteins. Methods 104 cases with stable bronchiectasis patients were randomly divided into two groups. The treatment group was treated with oral erythromycin and the control group was treated with placebo. After six months, the Chest CT imaging rates, resistance rates of oropharyngeal dominant bacteria, the amount of ROS and the activity of SOD in periph-eral blood mononuclear cells （ PBMC） of two groups were compared. Results After treatment, the chest CT images scores and other each item were improved significantly compared with that before treatment and the control group, and the difference was statistically sig-nificant （ P〈0.05）;The resistance rate of streptococci resistant to erythromycin of the treatment group was 34.62%, which was signifi-cantly higher than the control group （9.62%）;The amount of PBMC ROS in the treatment group was significantly lower, while its SOD was significantly higher than the control group, and the difference was statistically significant （P〈0.05）. Conclusion Patients with stable bronchiectasis infection by long-term low-dose oral erythromycin can improve chest CT imaging score, reduce oxidative stress protein content, and improve serum ROS and SOD content, which has good clinical efficacy, but it can improve the germs of macrolide resistance in some time.