阿法骨化醇联合阿奇霉素治疗慢性阻塞性肺疾病急性加重期的疗效  

Curative Effect of Alfacalcidol Combined with Azithromycin on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：郑岩 罗琳琳[2] 李秋根[2] 吕芷娴 ZHENG Yan LUO Lin-lin LI Qiu-gen LV Zhi-xian(2015 Grade of Medicine Department of Graduate School, Nanchang University, Nanchang 330006, China a. Department of Respiratory Disease Infection Management, J iangxi Provincial People ~ s Hospital 2b. Department of Hospital Nanchang 330006, China)

机构地区：[1]南昌大学研究生院医学部 [2]江西省人民医院呼吸内科,南昌330006 [3]江西省人民医院医院感染管理科,南昌330006

出　　处：《南昌大学学报（医学版）》2017年第4期21-23,46,共4页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金(30960143);江西省科技厅重大项目(20151BBB70267)

摘　　要：目的探讨阿法骨化醇联合阿奇霉素治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法将100例AECOPD患者按随机数字表法分为观察组和对照组,每组50例。2组均给予吸氧、解痉平喘及乳糖酸阿奇霉素治疗。在此基础上,观察组给予阿法骨化醇软胶囊治疗。观察2组治疗前、治疗15d后COPD评估测试(CAT)评分、第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼吸容积(FEV1)/用力肺活量(FVC)比值及血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、1,25-(OH)_2-D_3水平的变化。结果与对照组比较,观察组治疗15d后CAT评分和血清IL-6、TNF-α水平均降低更明显,FEV1%值、FEV1/FVC比值及血清1,25-(OH)_2-D_3水平均升高更明显(均P<0.05)。结论阿法骨化醇通过抑制炎症因子产生,从而辅助阿奇霉素减轻AECOPD气道炎症反应。Objective To investigate the clinical efficacy of alfacalcidol combined with azithromycin in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods One hundred patients with AECOPD were randomly divided into observation group and control group,with 50 patients in each group.Both groups were treated with oxygen inhalation,spasmolysis,antiasthma and intravenous drip of azithromycin.In addition,the observation group was given alfacalcidol capsules.The COPD assessment test（CAT）score,FEV1% pred,FEV1/FVC and serum levels of IL-6,TNF-αand 1,25-（OH）2-D3 were observed before and after treatment for 15 days.Results Compared with control group,the CAT score and serum IL-6and TNF-αlevels decreased but the FEV1% pred,FEV1/FVC and serum 1,25-（OH）2-D3 levels increased in observation group after treatment for 15days（P〈0.05）.Conclusion Alfacalcidol can assist azithromycin in alleviating airway inflammation in patients with AECOPD through inhibiting the production of inflammatory cytokines.

关 键 词：慢性阻塞性肺疾病 急性加重期 阿奇霉素 阿法骨化醇 炎症因子 疗效 

分 类 号：R563[医药卫生—呼吸系统] R453[医药卫生—内科学]