长期小剂量阿奇霉素治疗慢性阻塞性肺疾病稳定期的临床疗效研究

Clinical efficacy study of long-term small doses of azithromycin in the treatment of chronic obstructive pulmonary disease

目的探讨长期服用小剂量阿奇霉素治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法选取2013年7月—2015年3月南京医科大学附属苏州医院(本部)收治的COPD稳定期患者95例,按照随机数字表法将患者分为对照组46例与观察组49例。两组患者均给予常规治疗,观察组在此基础上给予口服小剂量阿奇霉素治疗,疗程1年。比较两组患者肺功能指标〔第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积占用力肺活量比值(FEV1/FVC)〕、COPD自我评估测试问卷(CAT)评分、病情首次加重所用时间、加重发作频率及不良反应发生情况。结果治疗前后两组患者FEV1%、FEV1/FVC比较,差异无统计学意义(P>0.05);治疗前两组患者CAT评分比较,差异无统计学意义(P>0.05);治疗后观察组患者CAT评分低于对照组,差异有统计学意义(P<0.05)。观察组患者病情首次加重所用时间长于对照组,病情加重发作频率少于对照组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 COPD稳定期患者长期服用小剂量阿奇霉素可减轻临床症状,延缓病情进展,改善生活质量。

Objective To investigate the clinical effect of long-term small doses of azithromycin in the treatment of chronic obstructive pulmonary disease( COPD). Methods A total of 95 cases of COPD patients were selected from July 2013 to March 2015 in Nanjing Medical University Affiliated Suzhou Hospital,which were divided into control group( n = 46) and observation group( n = 49) according to random number table method. All patients were given conventional therapy,the observation group was given small dose of oral azithromycin treatment for 1 years. The pulmonary function indexes( FEV1% 、FEV1/FVC),CAT score,the illness worse time for the first time,disease exacerbation frequency and incidence of adverse reactions were compared between the two groups. Results There was no statistically significant differences of FEV1% 、FEV1/ FVC before and after treatment between the two groups( P > 0. 05). Before treatment,there was no statistically significant difference of CAT scores between the two groups( P > 0. 05); after treatment,CAT scores of observation group were lower than control group( P < 0. 05). The observation group of the illness worse time for the first time was longer than control group,disease exacerbation frequency was less than control group( P < 0. 05). There was no statistically significant differences of adverse reactions rate between the two groups( P > 0. 05). Conclusion Long-term small doses of azithromycin in the treatment of COPD can reduce clinical symptoms,delay the progress of the disease and improve the quality of life.