瑞舒伐他汀钙对慢性阻塞性肺疾病不同高分辨CT表型的疗效分析  

Analysis of the efficacy of rosuvastatin calcium for different HRCT phenotypes of COPD

作　　者：周曦[1] 严峻海[1] 赵春柳[1] 黄卓琼 张柏膺[1] ZHOU Xi;YAN Jun-hai;ZHAO Chun-liu;HUANG Zhuo-qiong;ZHANG Bai-ying(Department of Respiratory Medicine, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院呼吸内科,上海200020

出　　处：《上海交通大学学报（医学版）》2016年第12期1759-1762,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会科研课题(20134161);上海市黄浦区卫生和计划生育委员会2013-2016年度优秀青年人才培养计划配套课题~~

摘　　要：目的·探讨瑞舒伐他汀钙对慢性阻塞性肺疾病(COPD)不同高分辨CT(HRCT)表型的疗效。方法·随机抽取COPD患者50例,通过对HRCT下的不同肺气肿和支气管壁增厚的表现,分成A、E、M 3型。在常规治疗的基础上,予以瑞舒伐他汀钙干预,5 mg/d,为期2年。于治疗开始前行胸部HRCT,进行分型;治疗前后检测患者血浆中的白介素6(IL-6)和白介素8(IL-8),以及肺功能。结果·50例COPD患者中,A型10例,E型17例,M型23例。3型患者IL-6、IL-8、用力肺活量(FVC)和第1秒用力呼气容积(FEV1)治疗前后差异均有统计学意义(均P<0.05)。3型间行单因素方差分析,IL-6、IL-8的下降幅度差异均有统计学意义(P=0.035,P=0.006),A型下降幅度最大;FVC和FEV1的下降幅度差异无统计学意义(P=0.154,P=0.453)。结论·瑞舒伐他汀钙对不同HRCT表型的COPD患者的全身炎症反应均有一定疗效,但对肺功能未观察到改善作用;不同表型间疗效有所差异。Objective · To investigate the efficacy of rosuvastatin calcium for different high-resolution CT (HRCT) phenotypes of COPD. Methods · FiftyCOPD patients were randomly selected and stratified into 3 types, i.e. A, E, M according to emphysema and bronchial wall thickening using HRCT.Based on conventional treatment, patients received 5 mg/d of rosuvastatin calcium for 2 years. Chest HRCT and type stratification were performed priorto treatment. Plasma IL-6 and IL-8 levels and lung function were measured before and after treatment. Results · There were 10 cases of A type, 17 casesof E type, and 23 cases of M type. Differences in IL-8, IL-6, FVC, and FEV1 before and after treatment between 3 types of patients were statisticallysignificant (P < 0.05). Univariate variance analysis showed that differences in the decrease of IL-6 and IL-8 were statistically significant (P = 0.035, P =0.006), which in A type patients decreased most. The differences in the decrease of FVC and FEV1 were not statistically significant (P=0.154, P = 0.453).Conclusion · Rosuvastatin calcium had efficacy for systemic inflammatory response in COPD patients with different HRCT phenotypes, but was unable toimprove pulmonary function. The efficacy for different phenotypes varied.

关 键 词：慢性阻塞性肺疾病 他汀类药物 电子计算机X 射线断层扫描技术 白介素6 白介素8 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]