阿托伐他汀对COPD稳定期患者气道重塑的影响

Effect of atorvastatin on airway remodeling in patients with COPD in stable phase

目的探究阿托伐他汀辅助治疗慢性阻塞性肺疾病(COPD)稳定期的疗效及对患者气道重塑的影响。方法将70例稳定期COPD患者随机分为试验组与对照组,各35例。均给予对症支持治疗,在此基础上,试验组睡前加服阿托伐他汀。比较两组治疗前后肺功能、气道重塑及炎症因子水平,以及治疗1年内住院情况。结果治疗后,两组肺功能、气道重塑及炎症因子均显著改善,但与对照组相比,试验组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC升高更明显,气道内径(L)、气道壁厚度(WT)、气道腔面积(AI)、气道总横截面积(AO)、气道壁面积(WA)改善效果更显著,血清白介素(IL)-8、肿瘤坏死因子(TNF)-α水平均更低(P <0.05)。与对照组相比,试验组治疗1年内再住院次数明显较少,再住院率明显较低(P <0.05),但两组病死率比较无统计学差异(P> 0.05)。结论阿托伐他汀可有效改善COPD稳定期患者气道重塑和肺功能,减轻炎症反应,并可降低再住院率,作为辅助治疗措施值得推广应用。

Objective To explore the efficacy of atorvastatin in the treatment of chronic obstructive pulmonary disease(COPD)in stable phase and its effect on airway remodeling.Methods A total of 70 patients with stable COPD were randomly divided into an experimental group and a control group(n=35,respectively).All patients were given symptomatic supportive treatment.On this basis,the experimental group was given atorvastatin before sleeping.The pulmonary function,airway remodeling and inflammatory factors were compared between the two groups before and after the treatment,and the hospitalization within one year after treatment.Results After the treatment,pulmonary function,airway remodeling and inflammatory factors were significantly improved in both groups,but compared with the control group,the first second forced expiratory volume(FEV1),forced vital capacity(FVC)and FEV1/FVC in the experimental group increased more significantly,and the airway inner diameter(L),airway wall thickness(WT),airway cavity area(AI),total airway cross-sectional area(AO),airway wall area(WA)improved significantly,and serum levels of interleukin(IL)-8 and tumor necrosis factor(TNF)-αwere significantly lower(P<0.05).Compared with the control group,the number of re-hospitalizations in the experimental group within one year was significantly less and the re-hospitalization rate was significantly lower(P<0.05),but there was no significant difference in mortality between the two groups(P>0.05).Conclusion Atorvastatin can effectively improve airway remodeling and pulmonary function,alleviate inflammation and reduce re-hospitalization rate in patients with stable COPD.It is worth popularizing as an adjuvant therapy.