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斯伐他汀联合布地奈德治疗老年中重度COPD稳定期患者效果及作用机制分析 被引量:3

Therapeutic effect and action mechanism of simvastatin plus budesonide in the treatment of elderly patients with moderate to severe COPD
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摘要 目的:研究斯伐他汀联合布地奈德治疗老年中重度COPD稳定期患者的效果及作用机制。方法:选取2017年6月至2018年6月广东省东莞市道滘医院收治的80例COPD并呼吸衰竭患者作为研究对象,采用随机数字表法均分为两组,每组各40例,其中对照组给予布地奈德气雾剂吸入治疗,观察组则加用斯伐他汀口服,治疗3个月后,比较两组治疗前后肺功能、运动耐量、生活质量及炎症因子水平以及治疗期间COPD急性发作情况。结果:治疗后,两组FEV1、FEV1%及FEV1/FVC均明显升高,且观察组FEV1、FEV1%及FEV1/FVC高于对照组(P<0.05);两组6MWT明显升高,SGRQ评分明显降低,且观察组6MWT高于对照组,SGRQ评分低于对照组(P<0.05);两组患者血清IL-6、LTB4、TNF-α、MMP-9及hs-CRP水平均明显降低(P<0.05),且观察组上述指标均低于对照组(P<0.05);治疗期间,观察组COPD急性发作次数和因COPD住院时间少于对照组(P<0.05)。结论:对于稳定期老年中重度COPD,斯伐他汀联合布地奈德可有效改善患者肺功能、运动耐量和生活质量,减少COPD急性发作,其机制可能与提升抗炎效果,减轻局部或全身炎症反应有关。 Objective:To investigate the therapeutic effect and action mechanism of simvastatin plus budesonide in the treatment of elderly patients with moderate to severe COPD.Methods:Eighty patients with COPD and respiratory failure admitted to Daojiao Hospital of Dongguan City,Guangdong Province between June 2017 and June 2018 were enrolled in the study.They were assigned to two groups by random number table(n=40 each).The control group was given inhaled budesonide,while the study group was given oral simvastatin in addition to inhaled budesonide.After 3 months of treatment,the two groups were compared for lung function,exercise endurance,quality of life,inflammatory factors before and after treatment,and acute exacerbations of COPD during the treatment.Results:After treatment,FEV1,FEV1%and FEV1/FVC were significantly increased in the two groups,and the FEV1,FEV1%and FEV1/FVC in the study group were higher than those in the control group(P<0.05).The 6MWT was significantly increased and the SGRQ score was significantly lowered in the two groups;the study group showed significantly higher 6MWD and lower SGRQ score compared with the control group(P<0.05).Serum levels of IL-6,LTB4,TNF-α,MMP-9 and hs-CRP were significantly lower in the two groups(P<0.05),and the these factors were lower in the study group compared with the control group(P<0.05).During the treatment,fewer number of acute COPD exacerbations and shorter length of hospital stay for COPD were noted for the study group compared with the control group(P<0.05).Conclusion:For stable moderate to severe COPD in elderly patients,simvastatin plus budesonide may effectively improve lung function,exercise endurance and quality of life,and reduce acute exacerbation of COPD.The action mechanism may be related to enhanced anti-inflammatory effects and reduced local or systemic inflammatory response.
作者 吴志强 刘汉坤 吴焕芳 Wu Zhiqiang;Liu Hankun;Wu Huanfang(Department of Internal Medicine,Dongguan Daojiao Hospital,Dongguan523176,Guangdong,China;Department of Surgery,Dongguan Daojiao Hospital,Dongguan523176,Guangdong,China)
出处 《广州医科大学学报》 2018年第6期57-60,共4页 Academic Journal of Guangzhou Medical University
关键词 中重度COPD 老年患者 斯伐他汀 布地奈德 作用机制 Moderate to severe COPD elderly patients simvastatin budesonide action mechanism
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