辛伐他汀联合噻托溴铵治疗慢性阻塞性肺病合并肺动脉高压的临床研究

Clinical trial of the simvastatin combined with tiotropium in the treatment of the chronic obstructive pulmonary disease patients with pulmonary hypertension

目的观察辛伐他汀联合噻托溴铵治疗慢性阻塞性肺病(COPD)合并肺动脉高压患者的疗效。方法将60例COPD合并肺动脉高压患者随机分为2组:对照组30例和试验组30例。对照组口服辛伐他汀每次20 mg,qd;试验组在对照组治疗的基础上,吸入噻托溴铵18μg,qd。2组患者均治疗3个月。测定2组患者的临床疗效、血氧分压(PO2)、血氧饱和度(Sp O2)、第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、外周动脉舒张压(PDBP)、外周动脉收缩压(PSBP)和外周血单核细胞Rho激酶1的水平并进行组间比较。结果治疗后,试验组和对照组的PO_2分别为(69. 10±4. 90)和(64. 72±2. 85) mm Hg;这2组的SpO_2分别为(89. 10±3. 79)和(86. 10±3. 84)%;这2组的FEV1分别为(1. 17±0. 14)和(0. 90±0. 11) L;这2组的FVC分别为(2. 16±0. 25)和(1. 77±0. 30) L;这2组的PDBP分别为(30. 72±1. 19)和(32. 28±1. 41) mm Hg;这2组的PSBP分别为(21. 24±1. 64)和(22. 83±1. 44) mm Hg;这2组的外周血单核细胞Rho激酶1分别为(38. 59±5. 66)和(42. 13±5. 52) pmol·L^(-1)。上述指标组间比较,差异均有统计学意义(均P <0. 01)。结论辛伐他汀联合噻托溴铵治疗COPD合并肺动脉高压患者临床疗效显著,可降低患者外周血单核细胞Rho激酶水平,缓解肺动脉压力,提高患者的生活质量。

Objective To observe the clinical trial of the simvastatin combined with tiotropium in the treatment of the chronic obstructive pulmonary disease(COPD)with pulmonary hypertension.Methods Sixty patients with COPD complicated with pulmonary hypertension were randomly divided into two groups:control group(n=30)and treatment group(n=30).The control group was treated with simvastatin,20 mg,qd,orally.On the basis of the control group,the treatment group was treated with tiotropium 18μg,qd,inhalation therapy.Both groups were treated for 3 months.Then clinical efficacy,the levels of the partial pressure of oxygen(PO2),oxygen saturation(SpO2),forced expiratory volume in one second(FEV1),forced vital capacity(FVC),peripheral artery diastolic blood pressure(PDBP),peripheral arterial systolic blood pressure(PSBP),and Rho kinase 1 in peripheral blood monocytes(ROCK1 in PBM)were determined and compared.Results After treatment,PO2 in treatment group and control group were(69.10±4.90)and(64.72±2.85)mm Hg;SpO2 in the two groups were(89.10±3.79)and(86.10±3.84)%;FEV1 in the two groups were(1.17±0.14)and(0.90±0.11)L;FVC in the two groups were(2.16±0.25)and(1.77±0.30)L;PDBP in the two groups were(30.72±1.19)and(32.28±1.41)mm Hg;PSBP in the two groups were(21.24±1.64)and(22.83±1.44)mm Hg;ROCK1 in PBM in the two groups were(38.59±5.66)and(42.13±5.52)pmol·L-1.Comparison between control group and treatment group,the difference of the factors were significantly(all P<0.01).Conclusion Simvastatin combined with tiotropium in the treatment of COPD with pulmonary hypertension is well,which can reduce the level of rhokinase in ROCK1,relieve pulmonary arterial pressure and improve the quality of life.