银杏达莫对AECOPD合并肺动脉高压的影响

Effect of Yinxingdamo on AECOPD with Pulmonary Hypertension

目的探讨银杏达莫对慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压的影响及其可能机制。方法选取2015年6月~2018年3月我院收治的120例AECOPD伴肺动脉高压患者,随机分为对照组和治疗组,每组60例。对照组予常规治疗,治疗组在对照组基础上加用银杏达莫注射液静滴,持续2周。比较两组患者治疗前后肺功能(FEV1、FEV1/FCV)、肺动脉收缩压(PASP)及舒张压(PADP)水平、血清中炎症因子(IL-6、TNF-α)及血管活性因子(ET-1、NO)浓度。结果两组患者治疗后FEV1、FEV1/FCV水平均较治疗前升高(P<0.05);治疗后,治疗组FEV1、FEV1/FCV分别为(2.02±0.53)L和(56.57±7.11)%,高于对照组的(1.85±0.46)L和(54.87±9.18)%(P<0.05);PASP及PADP水平均较治疗前下降(P<0.05);治疗组PASP及PADP分别为(48.92±10.53)mmHg和(22.13±3.16)mmHg,低于对照组的(57.35±11.46)mmHg和(26.73±4.27)mmHg(P<0.05);IL-6、TNF-α浓度均较治疗前下降(P<0.05);治疗组IL-6、TNF-α分别为(3.24±1.67)ng/L和(56.41±5.53)ng/ml,低于对照组的(4.64±1.52)ng/L和(63.77±7.65)ng/ml(P<0.05);两组患者治疗后ET-1浓度较治疗前降低,NO浓度较治疗前升高(P<0.05);治疗后两组比较,治疗组ET-1为(75.25±9.69)ng/L,低于对照组的(83.47±11.78)ng/L,治疗组NO为(56.41±8.93)μmol/L,高于对照组的(47.77±8.22)μmol/L(P<0.05)。结论银杏达莫能改善慢性阻塞性肺疾病急性加重期患者肺功能及肺动脉高压情况,其机制可能与降低炎症反应及影响血管活性因子相关。

Objective To investigate the effect of Yinxingdamo on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with pulmonary hypertension and its possible mechanism.Methods A total of 120 patients with AECOPD and pulmonary hypertension admitted to our hospital from June 2015 to March 2018 were randomly divided into control group and treatment group,with 60 cases in each group.The control group was given conventional treatment,and the treatment group was given an intravenous infusion of Yinxingdamo injection on the basis of the control group for 2 weeks.Pulmonary function (FEV1,FEV1/FCV),pulmonary systolic pressure (PASP) and diastolic blood pressure (PADP) levels,serum inflammatory factors (IL-6,TNF-α) and the concentration of vasoactive factors (ET-1,NO).Results The levels of FEV1 and FEV1/FCV in the two groups were higher than those before treatment (P<0.05).After treatment,the FEV1 and FEV1/FCV in the treatment group were (2.02±0.53)L and (56.57±7.11)%,respectively.The levels of PASP and PADP were lower than those in the control group (1.85±0.46)L and (54.87±9.18)%(P<0.05).The PASP and PADP levels were lower than those before treatment (P<0.05).The PASP and PADP in the treatment group were (48.92±10.53) mmHg and (22.13±3.16) mmHg,lower than (57.35±11.46) mmHg and (26.73±4.27) mmHg (P<0.05) in the control group;IL-6 and TNF-α concentrations were lower than before treatment (P<0.05);IL-6 and TNF-α in the treatment group were (3.24±1.67) ng/L and (56.41±5.53) ng/ml,respectively (4.64±1.52) ng/L and (63.77±7.65) Ng/ml (P<0.05);the concentration of ET-1 in the two groups was lower than that before treatment,and the concentration of NO was higher than that before treatment (P<0.05).After treatment,the ET-1 in the treatment group was (75.25±9.69) ng/L,which was lower than that of the control group (83.47±11.78) ng/L,the NO of the treatment group was (56.41±8.93)μmol/L,which was higher than that of the control group (47.77±8.22)μmol/L (P<0.05).Conclusion Yinxingdamo can improve pulmonary function and pulmonary hypertension in patients with acute exacerbation of chronic obstructive pulmonary disease.The mechanism may be related to the reduction of inflammatory response and the influence of vasoactive factors.