小剂量红霉素治疗稳定期支气管扩张症疗效观察

Clinical study of low-dose erythromycin in the treatment of bronchiectasis

目的:观察长期口服小剂量红霉素对稳定期支气管扩张症患者的临床疗效。方法:治疗组17例,口服红霉素0.125g,对照组10例,口服麦地霉素0.1g,均为每日3次,疗程3～5个月。治疗前后所有患者均行血常规、肝肾功能、痰细菌培养、肺功能、高分辨率CT检查,并记录治疗前后咳嗽、咳痰及治疗期间病情加重次数。结果:两组患者治疗前各项指标对比无统计学意义(P>0.05)。治疗期间治疗组与对照组相比较:人均急性发作数明显减少,(0.86±0.09)次/人vs(1.88±0.05)次/人(P<0.05);痰量减少,咳嗽减轻,中等以上疗效所占构成比明显高于对照组(P<0.01);FEV1/FVC(%)明显好转(P<0.05),FVC/pred(%)无明显变化(P>0.05);细菌清除率分别为85.7%、25.0%(P<0.05)。结论:长期口服小剂量红霉素可使稳定期支气管扩张症患者症状减轻,并可预防其急性加重。

Objective:To investigate the long-term clinical effect of erythromycin on bronchiectasis.Methods:Patients were randomly assigned to erythromycin therapy(treated group)or to midecamycin treatment (control group).The17patients in the treatment group received0.125g of erythromycin,the10patients in the controlled group took0.1g of midecamycin three times a day for3～5months.During the study,the frequency of exacerbation,the symptom of cough,and the amount and nature of sputum were recorded.Sputum culture,lung function tests and high-resolution CT were performed at both the beginning and the end of the observation.Results:The mean frequency of exacerbation for3～5months was signifi-cantly lower in the erythromycin group(0.86±0.09)than in the control group(1.88±0.05)(P<0.05).There was highly significant difference in the reduction of sputum and cough alleviation(P<0.01)between the two groups.The rate of bacterial clearance was significantly different (P<0.05)between the treatement group(85.7%)and the control group(25.0%)as well.Patients in the erythromycin group,had significantly im-proved forced expiratory volume in one second(P>0.05).Conclu sion:Low-dose erythromycin therapy has beneficial effects in the preventing of exacerbation in patients with bronchiectasis.