辛伐他汀联合阿奇霉素治疗老年慢性阻塞性肺疾病合并肺动脉高压患者的临床研究

Clinical trial of simvastatin combined with azithromycin in the treatment of elderly patients with chronic obstructive pulmonary disease and pulmonary hypertension

目的观察辛伐他汀联合阿奇霉素治疗老年慢性阻塞性肺疾病(COPD)合并肺动脉高压患者的疗效。方法将92例COPD合并肺动脉高压患者随机分为试验组46例和对照组46例。2组患者均给予常规治疗。对照组给予辛伐他汀,每次20 mg,每天1次,口服。试验组在对照组的基础上给予阿奇霉素分散片,每次0.125 g,每天1次,口服。2组患者均连续治疗14 d。比较治疗前后2组患者的细胞因子水平、肺功能、肺动脉压、血气分析及6 min步行试验距离。结果治疗后,试验组及对照组内皮素-1(ET-1)水平为(3.25±0.85),(3.68±0.83)μg·L^-1,C-反应蛋白(CRP)水平为(4.23±0.64),(5.67±0.93)mg·L^-1,肿瘤坏死因子-α(TNF-α)水平为(75.66±22.14),(93.25±25.63)pg·mL^-1,肺动脉收缩压(PAPs)水平为(32.53±0.46),(36.13±0.36)mmHg,肺动脉舒张压(PAPd)水平为(22.42±0.31),(27.75±0.42)mmHg,1秒用力呼气容积(FEV1)水平为(1.25±0.21),(0.99±0.21)L,用力肺活量(FVC)水平为(2.23±0.27),(1.91±0.18)L,动脉氧分压(PaO2)水平为(71.45±4.34),(65.04±4.93)mmHg,动脉血氧饱和度(SaO2)水平为(92.24±4.56)%,(85.57±6.41)%,6 min步行试验距离水平为(398.24±53.24),(317.56±43.29)m,组间差异均有统计学意义(均P<0.05)。2组患者均未因服药出现药物不良反应。结论辛伐他汀联合阿奇霉素可有效抑制老年COPD合并肺动脉高压患者炎症反应,降低肺部动脉血压,改善肺通气功能及血气分析指标,未增加安全风险。

Objective To explore the effects of simvastatin combined with azithromycin in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary hypertension.Methods Ninety-two patients with COPD combined with pulmonary hypertension were randomly divided into treatment group(46 cases)and control group(46 cases).Both groups were given routine treatment.Control group was given simvastatin 20 mg,once a day,oral.Treatment group was given azithromycin dispersible tablets on the basis of control group,0.125 g,once a day,oral.Both groups were treated continuously for 14 d.The levels of cytokines,pulmonary function,pulmonary artery pressure,blood gas analysis and the 6 min walking distance werecompared between the two groups.Results After treatment,the endothelin-1(ET-1)levels in treatment group and control group were(3.25±0.85),(3.68±0.83)g·L^-1,C-reactive protein(CRP)levels were(4.23±0.64),(5.67±0.93)mg·L^-1,tumor necrosis factor-α(TNF-α)levels were(75.66±22.14),(93.25±25.63)pg·mL^-1,the pulmonary artery systolic pressure(PAPs)were(34.23±0.43),(36.69±0.36)mmH g,the pulmonary artery diastolic pressure(PAPd)were(24.13±0.35),(28.09±0.42)mmH g,the one-second forced expiratory volume(FEV1)levels were(1.25±0.21)and(0.99±0.21)L,the forced vital capacity(FVC)levels were(2.23±0.27)and(1.91±0.18)L,the partial pressure of arterial oxygen(PaO2)levels were(71.45±4.34)and(65.04±4.93)mmH g,the arterial oxygen saturation(SaO2)levels were(92.24±4.56)%and(85.57±6.41)%,the 6 min walking distance were(398.24±53.24)and(317.56±43.29)m,all with significant differences(all P<0.05).No adverse reactions were found in both groups.Conclusion Simvastatin combined with azithromycin can effectively inhibit inflammatory response in elderly patients with COPD complicated with pulmonary hypertension,reduce pulmonary arterial blood pressure,improve pulmonary ventilation function and blood gas analysis index,without increasing safety risk.