阿奇霉素联合辛伐他汀对慢性阻塞性肺疾病合并肺动脉高压的治疗效果

Efficacy of azithromycin combined with simvastatin in the treatment of patients with chronic obstructive pulmonary disease with pulmonary hypertension

目的探讨阿奇霉素与辛伐他汀联合治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压的效果,为临床COPD合并肺动脉高压的治疗提供可靠依据。方法选取2016年5月—2017年6月广东省梅州市五华县人民医院收治的178例COPD合并肺动脉高压患者,随机分为观察组和对照组,每组89例。其中,对照组给予常规对症治疗和辛伐他汀治疗,观察组在对照组的治疗基础上加用阿奇霉素,对比两组的肺收缩压、舒张压、肺功能指标[6 min步行距离、用力呼气容积(FVE1)和用力肺活量(FVC)]、C反应蛋白(CRP)水平及不良反应等。结果治疗6个月后,观察组患者的肺收缩压及舒张压均低于对照组患者(P<0.05);观察组患者治疗后的6 min步行距离比对照组长,且FVC和FEV1均高于对照组(P<0.05);治疗后,两组的CRP水平均明显降低,其中观察组降低幅度比对照组大(P<0.05);两组患者均未发生不良反应。结论阿奇霉素与辛伐他汀的联合应用有助于降低COPD合并肺动脉高压患者的肺动脉压,改善肺功能,缓解炎症反应,且无不良反应,用药安全,可提高患者生存质量。

Objective To investigate the efficacy of azithromycin combined with simvastatin in the treatment of chronic obstructive pulmonary disease(COPD) complicated with pulmonary hypertension. Methods Totally 178 cases of patients with COPD complicated with pulmonary hypertension were selected from Wuhua County People's Hospital during May 2016 to June 2017, and they were randomly divided into two groups. The control group was given routine symptomatic treatment and simvastatin treatment. On the basis of treatment in control group, the observation group was treated with azithromycin.The indexes such as pulmonary systolic pressure, diastolic pressure, pulmonary function(6 min walking distance, FEV1, FVC), C reactive protein and adverse reactions were observed. Results After6 months of treatment, compared to the control group, the pulmonary systolic pressure and diastolic pressure were lower(P<0.05), the 6 min walking distance was longer, and the FVC and FEV1 were higher in the observation group(all P<0.05). After treatment, the serum C reactive protein levels of the two groups were significantly decreased, especially in the observation group(P<0.05). Patients in two groups did not have adverse reactions. Conclusions The combination of azithromycin and simvastatin can reduce the pulmonary arterial pressure in patients with COPD and pulmonary hypertension, improve the pulmonary function, alleviate the inflammatory reaction, and have no adverse reactions, can improve the life quality of patients.