间歇性使用罗红霉素预防小腹部主动脉瘤进展：一项小型临床试验的长期结果
Intermittent roxithromycin for preventing progression of small abdominal aortic aneurysms: long-term results of a small clinical trial.
作者信息
Høgh Annette, Vammen Steen, Ostergaard Lars, Joensen Jette B, Henneberg Esklid W, Lindholt Jes S
机构信息
Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Denmark.
出版信息
Vasc Endovascular Surg. 2009 Oct-Nov;43(5):452-6. doi: 10.1177/1538574409335037. Epub 2009 Jul 29.
BACKGROUND
Antibodies against Chlamydia pneumoniae are associated with an increased rate of expansion of small abdominal aortic aneurysms (AAAs). Short-term follow-up trials have shown a transient reduction AAA growth rate, in macrolide treated compared with placebo. Therefore we analysed the influence of intermittent, long-term roxithromycin treatment on AAA expansion and referral for surgery.
METHODS
Eighty-four patients with small AAAs were randomized to either an annual 4 weeks' treatment with roxithromycin or placebo, and followed prospectively.
RESULTS
Intermittent, long-term Roxithromycin-treatment reduced mean annual growth rate by 36% compared with placebo after adjustment for potential confounders. Long-term roxithromycin-treated patients had a 29% lower risk of being referred for surgical evaluation, increasing to 57% after adjusting for potential confounders.
CONCLUSION
Annual 4 week treatment with 300 mg roxithromycin daily may reduce the progression of small AAAs, and later need for surgical repair. However, more robust studies are needed for confirmation.
背景
抗肺炎衣原体抗体与小腹主动脉瘤（AAA）扩张率增加有关。短期随访试验表明，与安慰剂相比，大环内酯类药物治疗可使AAA生长率暂时降低。因此，我们分析了间歇性长期服用罗红霉素治疗对AAA扩张及手术转诊的影响。
方法
84例小AAA患者被随机分为接受每年4周的罗红霉素治疗或安慰剂治疗，并进行前瞻性随访。
结果
在对潜在混杂因素进行校正后，与安慰剂相比，间歇性长期罗红霉素治疗使平均年增长率降低了36%。长期接受罗红霉素治疗的患者接受手术评估的风险降低了29%，在对潜在混杂因素进行校正后，这一比例增至57%。
结论
每天300mg罗红霉素进行每年4周的治疗可能会减缓小AAA的进展，并降低后期手术修复的必要性。然而，需要更有力的研究来证实这一点。
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