阿奇霉素联合阿托伐他汀治疗慢性阻塞性肺疾病合并肺动脉高压的临床效果  

Clinical effect of azithromycin combined with atorvastatin in the treatment of chronic obstructive pulmonary disease with pulmonary hypertension

作　　者：杨丹 李业彪[1] 杨广权 YANG Dan;LI Yebiao;YANG Guangquan(Department of Respiratory and Critical Care Medicine,Guangdong Agricultural Reclamation Central Hospital,Guangdong Province,Zhanjiang 524000,China)

机构地区：[1]广东省农垦中心医院呼吸与危重症医学科,广东省湛江市524000

出　　处：《临床合理用药》2025年第7期10-13,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：湛江市非资助科技攻关计划项目(2023B01115)。

摘　　要：目的观察阿奇霉素联合阿托伐他汀治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)的临床效果。方法选取2022年1月—2024年1月广东省农垦中心医院收治的COPD合并PH患者150例,依据随机数字表法分为观察组和对照组,每组75例。对照组给予阿托伐他汀治疗,观察组给予阿奇霉素联合阿托伐他汀治疗,2组均治疗2个月。比较2组临床疗效,治疗前后肺功能指标[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)、最大呼气中段流量(MMEF)、FEV_(1)/用力肺活量(FVC)、一氧化碳弥散量(DLCO)]、临床相关指标[降钙素原(PCT)、白细胞计数(WBC)、C反应蛋白(CRP)、肺动脉收缩压(PASP)],不良反应。结果观察组总有效率为97.33%,高于对照组的88.00%(χ^(2)=4.807,P=0.028)。治疗2个月后,2组FEV_(1)、PEF、MMEF、FEV_(1)/FVC及DLCO均高于治疗前,且观察组高于对照组(P<0.01);2组PCT、WBC均高于治疗前,而观察组升高幅度小于对照组,2组CRP、PASP均低于治疗前,且观察组低于对照组(P<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(6.67%vs.4.00%,χ^(2)=0.528,P=0.467)。结论阿奇霉素联合阿托伐他汀治疗COPD合并PH可改善患者肺功能及炎性反应指标,降低PASP,确保治疗有效性及安全性。Objective To observe the clinical effect of azithromycin combined with atorvastatin in the treatment of chronic obstructive pulmonary disease(COPD)complicated with pulmonary hypertension(PH).Methods A total of 150 patients with COPD combined with PH treated in Guangdong Agricultural Reclamation Central Hospital from January 2022 to January 2024 were selected and divided into observation group and control group according to random number table method,with 75 patients in each group.Control group was given atorvastatin treatment,observation group was given azithromycin combined with atorvastatin treatment,both groups were treated for two months.The clinical efficacy,pulmonary function indicators(FEV_(1),PEF,MMEF,FEV_(1)/FVC,DLCO),clinically relevant indicators(PCT,WBC,CRP,PASP)before and after treatment,adverse reactions of the two groups were compared.Results The total effective rate of observation group was 97.33%,which was higher than that of control group(χ^(2)=4.807,P=0.028).After 2 months of treatment,FEV_(1),PEF,MMEF,FEV_(1)/FVC and DLCO in two groups were higher than before treatment,and observation group was higher than control group(P<0.01).PCT and WBC in two groups were higher than before treatment,but the increases in observation group were lower than those in control group,CRP and PASP in two groups were lower than before treatment,and observation group was lower than control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between observation group and control group(6.67%vs.4.00%,χ^(2)=0.528,P=0.467).Conclusion Azithromycin combined with atorvastatin in the treatment of COPD combined with PH can improve lung function and inflammatory response indexes,reduce PASP,and ensure the efficacy and safety of treatment.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 阿奇霉素 阿托伐他汀 肺功能 肺动脉收缩压 

分 类 号：R56[医药卫生—呼吸系统]