小剂量克拉霉素对慢性阻塞性肺疾病的临床应用研究  

Clinical effects of low dose clarithromycin on chronic obstructive pulmonary diseases

作　　者：徐伟芳[1] 

机构地区：[1]杭州市第四人民医院内科,浙江杭州310002

出　　处：《全科医学临床与教育》2009年第5期461-463,共3页Clinical Education of General Practice

摘　　要：目的观察小剂量克拉霉素对稳定期重度慢性阻塞性肺疾病(COPD)患者的肺功能、生活质量、急性发作的影响。方法将60例稳定期重度COPD患者随机分成观察组和对照组。观察组给予克拉霉素片250mg一日一次口服,持续12周,对照组不用任何药物。观察两组患者治疗前后的第一秒用力呼气容积占预计值百分比(FEV1%)、圣乔治呼吸问卷(SGRQ)测定的生活质量,并记录两组12周内急性发作的人数。结果观察组治疗后FEV1%、SGRQ评分与对照组比较,差异均有统计学意义(t分别=3.11、2.17、2.26、4.97、3.23,P均<0.05);与治疗前比较,差异均有统计学意义(t分别=2.33、2.79、2.03、3.44、3.14,P均<0.05)。仅2例有轻微胃肠道反应,继续用药后症状减轻,所有患者均完成12周的治疗。治疗后复查肝肾功能均在正常范围。12周内观察组急性发作4人,对照组急性发作11人。两组比较,差异有统计学意义(χ2=4.36,P<0.05)。结论长期应用小剂量克拉霉素可以改善稳定期重度COPD的肺功能、生活质量、减少急性发作。Objective To explore the influence of low dose clarithromycin on pulmonary function, life quality and acute episode of severe chronic obstructive pulmonary diseases （COPD） patients in stable phase. Methods Sixty stable phase severe COPD patients were divided into treatment group and control group. The treatment group was given clarithromycin 250rag qd for 12 weeks and the control group was with no treatment. Expiratory volume prediction percentage and SGRQ were detected. The number of acute episode patients in 12 weeks was recorded. Results Significant differences of the FEV1% and SGRQ score were found between the treatment group and control group （t=-3.11,2.17,2.26,4.97,3.23 ,P〈0.05）. Significant differences of the FEV1% and SGRQ score in treatment group were also observed before and after treatment （t=2.33,2.79,2.03,3.44,3.14,P〈0.05）. Mild gastrointestinal symptoms were found during the treatment only in 2 eases and alleviated with the continuing treatment. Four patients had acute episode in the treatment group and 11 in the control group. The difference was significant （x^2=4.36,P〈0.05）. Conclusions Using low dose clarithromycin for long time could improve the pulmonary function, life quality and decrease acute episode in stable phase severe COPD patients.

关 键 词：小剂量克拉霉素 慢性阻塞性肺疾病 抗炎和免疫调节作用 

分 类 号：R563.9[医药卫生—呼吸系统]