阿奇霉素治疗慢性阻塞性肺疾病患者肺炎衣原体慢性感染  

Azithromycin in the Treatment of Patients with Chronic Chlamydia Pneumoniae Infection and Chronic Obstructive Pulmonary Disease

作　　者：储德节[1] 胡志雄[1] 郭水根[1] 马力[1] 孙书明[1] 

机构地区：[1]复旦大学附属金山医院呼吸内科职业病防治所,上海200540

出　　处：《中国临床医学》2010年第1期30-32,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨阿奇霉素治疗慢性阻塞性肺病(COPD)患者肺炎衣原体(Cpn)慢性感染的疗效。方法:选择COPD稳定期患者合并Cpn慢性感染者65例,随机分为对照组(30例)和治疗组(35例),分别口服安慰剂(淀粉片)和阿奇霉素(500mg.d-1)治疗,连续服用5d、停用23d为1个疗程,重复3个疗程。治疗前及疗程结束后进行临床症状评分,检测肺功能的FEV1/FVC(%)、高敏C-反应蛋白(Hs-CRP)、Cpn-IgG和Cpn-IgA。结果:65例均完成试验,治疗组与对照组相比,临床症状改善[治疗组:治疗前(2.60±0.50)分,治疗后(1.70±0.28)分,P<0.05];FEV1/FVC(%)也有改善[治疗组:治疗前(57±9)%,治疗后(60±7)%,P<0.05];Hs-CRP较前下降[治疗组治疗前(4.54±0.65)mg.L-1,治疗后(3.80±0.5)mg.L-1,P<0.05];Cpn-IgG阳性率和Cpn-IgA阳性率均下降,均有统计学意义。结论:阿奇霉素治疗COPD患者Cpn慢性感染有一定疗效,可改善临床症状及肺功能,减轻炎性反应。Objective：To evaluate the efficacy of azithromycin in the treatment of chronic Chlamydia pneumoniae infection of the chronic obstructive pulmonary disease （COPD） patients. Methods： It was a prospective randomized, placeboo controlled clinical trial. There were sixty five stable-staged COPD patients enrolled and assigned into two groups. Thirty five cases of the study group were given azithromycin 500 mg once daily by oral administration, and thirty cases of the control group were re- ceived the oral placebo of starch pill, one course of treatment was that took the medicine for 5 days, and then stopped oral ad- ministration for 23 days（named one course of treament）, which course were repeated 3 times. Before and after the intervention, both were recorded symptom scores, pulmonary function of FEV1/FVC（%）, plasma levels of high sensitivity C-reactive pro- tein （Hs-CRP）, Cpn-IgG and Cpn IgA. Results： There were 65 patients who fulfilled the study tests; 35 patients of the treated group got improved clinical scores, （2.60± 0.50 vs. 1.70 ± 0.28, P〈0.05） ; FEV1/FVC（ % ） also increased, [（57± 9） % vs. （60±7）%, P〈0.05] ; plasma levels of Hs-CRP [（4.54 ±0.65）mg·L^-1 （3.80 ± 0.5）mg · L^-1] ; Cpn-IgG Positive 23 cases before treatment, 13 cases after treatment,P〈0.05; Cpn-IgApositive 19 cases before treatment, 12 cases after treatment,P〈 0.05. Conclusions： Azhirhromycin used for treating the chronic Chlamydia pneumonia infection of the COPD patients is able to relieve the clinical symptom and improve the lung function, decrease the plasma levels of Hs-CRP, Cpn-IgG and Cpn-IgA.

关 键 词：慢性阻塞性肺疾病 阿奇霉素 肺炎衣原体 慢性感染 

分 类 号：R518[医药卫生—内科学]