阿奇霉素联合沙美特罗替卡松对稳定期慢性阻塞性肺疾病患者气道炎症反应及气道阻力的影响

Effects of azithromycin combined with seretide on airway inflammation response and airway resistance in patients with stable chronic obstructive pulmonary disease

目的:研究阿奇霉素联合沙美特罗替卡松对稳定期慢性阻塞性肺疾病(COPD)患者气道炎症反应及气道阻力的影响。方法:抽取河南大学淮河医院2014年2月至2019年2月收治的稳定期COPD患者248例为研究对象,按照随机数字表法分为观察组和对照组,每组124例。对照组给予沙美特罗替卡松治疗,观察组给予阿奇霉素联合沙美特罗替卡松治疗,共治疗2个月。比较两组治疗前后血清及诱导痰上清液中白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平,第1 s用力呼气容积(FEV1)、最大肺活量(FVC),周边气道黏性阻力(R5-R20),慢性阻塞性肺病评估测试问卷(CAT)、改良英国医学研究理事会呼吸困难指数(mMRC)、6 min步行试验(6MWT)评分。结果:治疗后,两组血清IL-8、TNF-α水平比较差异未见统计学意(P>0.05),观察组诱导痰上清液IL-8、TNF-α水平低于对照组(P<0.05)。治疗后,观察组FEV1、FVC、FEV1/FVC均高于对照组(P均<0.05);观察组治疗后总气道黏性阻力、R5-R20值低于对照组(P<0.05);观察组治疗后CAT、mMRC评分低于对照组(P<0.05),6MWT评分高于对照组(P<0.05)。结论:稳定期COPD患者使用阿奇霉素联合沙美特罗替卡松治疗能有效改善气道炎症水平,同时改善肺功能及气道阻力,进而提高其生活质量及健康状况。

Objective:To study the effects of azithromycin combined with seretide on airway inflammation response and airway resistance in patients with stable chronic obstructive pulmonary disease(COPD).Methods:A total of 248 patients with stable COPD who were admitted to the Huaihe Hospital of Henan University from February 2014 to February 2019 were enrolled.They were randomly divided into observation group and control group by random number table method,with 124 cases in each group.The control group was given seretide,while the observation group was given azithromycin combined with seretide.Both groups were treated for 2 months.The levels of interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in serum and induced sputum supernatant,values of first expiratory volume in 1 s(FEV1),forced vital capacity(FVC),FEV1/FVC,peripheral airway viscous resistance(R5-R20),scores of COPD Assessment Test(CAT),modified British medical research council(mMRC)and 6-Minute Walk Test(6MWT)of the two groups before and after treatment were compared.Results:After treatment,there was no significant difference in levels of serum IL-8 and TNF-αbetween the two groups(P>0.05).The levels of IL-8 and TNF-αin induced sputum supernatant of observation group were lower than those of control group(P<0.05).After treatment,FEV1,FVC and FEV1/FVC in observation group were higher than those in control group(P<0.05),while values of total respiratory airway viscous resistance and R5-R20 were lower than those in control group(P<0.05).The scores of CAT and mMRC of observation group were lower than those of control group(P<0.05),and 6MWT was higher than that of control group(P<0.05).Conclusions:The application of azithromycin combined with seretide in treatment of stable COPD can effectively improve airway inflammation level,lung function and airway resistance,thus improving their quality of life and health status.