阿托伐他汀治疗慢性阻塞性肺疾病患者的临床研究

Clinical study of atorvastatin in treatment of patients with chronic obstructive pulmonary disease

目的 探讨阿托伐他汀对慢性阻塞性肺疾病(COPD)患者肺功能及Th1/Th2和Th17/Treg平衡的影响。方法 将208例COPD患者随机分为对照组103例和试验组105例。2组均给予常规治疗;对照组在常规治疗基础上给予沙美特罗替卡松气雾剂,每次1吸,每天2次;试验组在对照组的基础上口服阿托伐他汀钙片,每次20 mg,每天1次。2组患者均连续治疗4周。比较2组患者的肺功能、临床疗效、炎症因子水平及Th1/Th2、Th17/Treg情况,观察2组患者药物不良反应的发生情况。结果 治疗后,对照组和试验组患者用力肺活量(FVC)分别为(2.95±0.36)和(3.27±0.43)L;最大呼气峰流速(PEF)分别为(4.89±0.78)和(5.41±0.81)L·s^(-1);第一秒用力呼气容积(FEV1)/FVC分别为(56.24±9.05)%和(60.98±9.82)%;可溶性细胞间黏附分子-1(sICAM-1)分别为(83.69±11.04)和(71.47±9.96)μg·L^(-1);转化生长因子-β1(TGF-β1)分别为(359.27±28.63)和(320.18±24.52)ng·L^(-1);白细胞介素-4(IL-4)分别为(38.21±6.24)和(33.17±5.47)ng·L^(-1);白细胞介素-17(IL-17)分别为(40.03±7.01)和(35.12±6.48)ng·L^(-1);Th1/Th2分别为5.56±0.87和4.97±0.81;Th17/Treg分别为5.18±0.76和4.53±0.72。上述指标,对照组和试验组比较,差异均有统计学意义(均P<0.05)。治疗后,对照组和试验组的总有效率分别为77.23%(78例/101例)和89.32%(92例/103例),差异有统计学意义(P<0.05)。对照组和试验组的总药物不良反应发生率分别为4.95%(5例/101例)和5.83%(6例/103例),差异无统计学意义(P>0.05)。结论 阿托伐他汀用于COPD患者可明显改善肺功能,增强治疗效果,抑制炎症反应,改善免疫功能,且安全性良好。

Objective To investigate the effect of atorvastatin on pulmonary function and the balance of Th1/Th2 and Th17/Treg in patients with chronic obstructive pulmonary disease(COPD). Methods A total of 208 cases COPD patients were randomly divided into control group of 103 cases and a treatment group of 105 cases. Both groups were given routine treatment. The control group was given salmeterol fluticasone aerosol, 1 inhalation per time, twice a day on the basis of conventional treatment;the treatment group was given atorvastatin calcium tablet orally on the basis of treatment group, 20 mg each time, once a day. Both groups were treated for 4 consecutive weeks. The pulmonary function, clinical efficacy, levels of inflammatory factors, Th1/Th2, Th17/Treg,and adverse drug reactions were compared between the two groups. Results After treatment,forced vital capacityies( FVC) of the control group and treatment group were( 2. 95 ± 0. 36) and( 3. 27 ± 0. 43) L,respectively;maximum expiratory peak flow rates( PEF) were( 4. 89 ± 0. 78) and( 5. 41 ± 0. 81) L·s^(-1),respectively;first second forced expiratory volumes( FEV1)/FVC were( 56. 24 ± 9. 05) % and( 60. 98 ± 9. 82) %,respectively;soluble intercellular adhesion molecule-1( s ICAM-1) were( 83. 69 ± 11. 04) and( 71. 47 ± 9. 96) μg·L^(-1),respectively;transforming growth factor-β1( TGF-β1) were( 359. 27 ± 28. 63) and( 320. 18 ± 24. 52) ng·L^(-1),respectively;interleukin-4( IL-4) were( 38. 21 ± 6. 24) and( 33. 17 ± 5. 47) ng · L-1,respectively;interleukin-17( IL-17) were( 40. 03 ± 7. 01) and( 35. 12 ± 6. 48) ng · L-1,respectively;Th1/Th2 were 5. 56 ± 0. 87 and 4. 97 ± 0. 81,respectively;Th17/Treg were 5. 18 ± 0. 76 and 4. 53 ± 0. 72, respectively. There were statistically significant differences between the control group and the treatment group( all P < 0. 05). After treatment,the total effective rates of control group and experimental group were 77. 23%( 78 cases/101 cases) and 89. 32%( 92 cases/103 cases),respectively,the difference was statistically significant( P < 0. 05). The total incidences of adverse drug reactions in control group and treatment group were 4. 95%( 5 cases/101 cases) and 5. 83%( 6 cases/103 cases),respectively,with no statistical significance( P > 0. 05). Conclusion Atorvastatin for COPD patients can significantly improve lung function,enhance therapeutic effect,inhibit inflammatory response,improve immune function,and has good safety.