瑞舒伐他汀钙治疗慢性阻塞性肺疾病急性加重期合并肺动脉高压

Rosuvastatin calcium in the treatment of acute exacerbation of chronic obstructive pulmonary disease combined with pulmonary artery hypertension

目的观察瑞舒伐他汀钙对慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)患者炎症因子及肺功能的影响。方法选取2015年12月至2016年12月收治的AECOPD合并PH患者60例,按照随机数字表法分为对照组和观察组,各30例。两组患者均给予抗炎、止咳化痰等常规基础药物治疗,观察组在常规基础药物上加服瑞舒伐他汀钙10 mg,每晚一次,两组均治疗24周。观察治疗前后两组患者肺功能(FEV1、FVC、PEF、FEV1/FVC)、白介素-6(IL-6)、半乳糖凝集素(Gal-3)、中性粒细胞弹性蛋白酶(NE)及肺动脉压力的变化。结果治疗前两组患者FEV1、FVC、PEF、FEV1/FVC、IL-6、Gal-3、NE及肺动脉压力比较差异无统计学意义(P> 0. 05)。治疗24周后,两组患者FEV1、FVC、PEF、FEV1/FVC均较治疗前明显升高(P <0. 05),且观察组显著高于对照组(P <0. 01);两组患者IL-6、Gal-3、NE水平均较治疗前明显下降(P <0. 01),且观察组显著低于对照组(P <0. 05);两组患者肺动脉压力均较治疗前明显下降(P <0. 01),且观察组显著低于对照组(P <0. 05)。结论瑞舒伐他汀钙能明显降低AECOPD合并PH患者肺动脉压力、炎症因子水平,有效改善患者肺功能。

Objective To observe the impacts of rosuvastatin calcium on inflammatory factors and pulmonary function in the patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） combined with pulmonary artery hypertension. Methods A total of 60 AECOPD patients treated from December 2015 to December 2016 were selected and randomly divided into control group and study group（n = 30,each）. The conventional drug treatment was given for antiinflammatory,cough relieving and expectorant and so on in two groups,rosuvastatin calcium（10 mg,once a night） was added in study group. The therapy was continued for 24 weeks in both two groups. The changes of pulmonary function including forced expiratory volume in one second（FEV1）,forced vital capacity（FVC）,peak expiratory flow（PEF）,FEV1/FVC,levels of interleukin-6（IL-6）,galactose agglutinin（Gal-3） and neutrophil elastase（NE）,pulmonary arterial pressure were observed before and after treatment in two groups. Results Before treatment,there were no significant differences in FEV1,FVC,PEF,FEV1/FVC,IL-6,Gal-3,NE and pulmonary pressure between two groups（all P〈0. 05）.At 24 weeks after treatment,FEV1,FVC,PEF and FEV1/FVC were significantly higher than those before treatment in both two groups（all P〈0. 05） and were obviously higher in study group than those in control group（all P〈0. 05）. The levels of IL-6,Gal-3,NE significantly decreased at 24 weeks after treatment compared with those before treatment in both two groups（all P〈0. 05） and were obviously lower in study group than those in control group（all P〈0. 05）. Pulmonary pressure significantly decreased after treatment in both two groups compared with before treatment（all P〈0. 05） and was obviously lower in study group than that in control group（P〈0. 05）. Conclusion Rosuvastatin calcium can significantly reduce pulmonary artery hypertension and levels of inflammatory factors and improve pulmonary function effectively in the patients with acute exacerbation of chronic obstructive pulmonary disease.