Wang Peidong, Yang Jie, Yang Yanwei, Ding Zhixin
Peidong Wang, Department of Pulmonary Disease, Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, 450007, China.
Jie Yang, Department of Pulmonary Disease, Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou, 450007, China.
Pak J Med Sci. 2017 Mar-Apr;33(2):260-264. doi: 10.12669/pjms.332.11717.
To evaluate the effect of azithromycin in combination with simvastatin in the treatment of chronic obstructive pulmonary disease (COPD) complicated by pulmonary arterial hypertension.
Eighty-six patients who developed COPD and pulmonary arterial hypertension and received treatment from August 2013 to October 2014 were selected and randomly divided into an observation group and a control group using random number table, 43 in each group. Patients in the control group were orally administrated 20 mg of simvastatin, once a day. Patients in the observation group took 0.25g of azithromycin enteric-coated tablets, once a day, besides simvastatin. The treatment course of both groups was six months. Blood gas analysis indexes, forced expiratory volume in first second (FEV), six minutes walking distance, dyspnea grade and blood lipid parameter were recorded and compared between the two groups.
Arterial partial pressure of oxygen (PaO) and arterial partial pressure of carbon dioxide (PaCO) of the observation group were (68.13±3.03) mmHg and (45.08±2.27) mmHg after treatment, respectively. In the control group, the values were (60.01±4.72) mmHg and (38.93±1.61) mmHg, respectively. The improvement amplitude of the observation group was superior to that of the control group (<0.05). FEV, forced vital capacity (FVC) and 6-minutes walking distance of the observation group were (1.08±0.11) L, (2.1±0.2) L and (380.34 ± 31.28) m respectively after treatment, superior to the control group ((0.93±0.09) L, (1.7±0.1) L) and (302.79±29.74) m, and the difference had statistical significance (<0.05). The levels of peripheral systolic blood pressure (PSBP) and peripheral diastolic blood pressure (PDBP) of patients in the observation group were both lower than those of the control group, and the difference had statistical significance (<0.05).
Azithromycin in combination with simvastatin has definite effect in the treatment of COPD in combination with pulmonary arterial hypertension as it can significantly relieve ventilation disturbance, improve lung function, and decrease pulmonary arterial pressure. Hence it is worth clinical promotion.
评估阿奇霉素联合辛伐他汀治疗慢性阻塞性肺疾病（COPD）合并肺动脉高压的效果。
选取2013年8月至2014年10月期间收治的86例COPD合并肺动脉高压患者，采用随机数字表法将其随机分为观察组和对照组，每组43例。对照组患者口服辛伐他汀20mg，每日1次。观察组患者在服用辛伐他汀的基础上，加服阿奇霉素肠溶片0.25g，每日1次。两组疗程均为6个月。记录并比较两组的血气分析指标、第1秒用力呼气容积（FEV）、6分钟步行距离、呼吸困难分级及血脂参数。
治疗后观察组动脉血氧分压（PaO）和动脉血二氧化碳分压（PaCO）分别为（68.13±3.03）mmHg和（45.08±2.27）mmHg，对照组分别为（60.01±4.72）mmHg和（38.93±1.61）mmHg。观察组改善幅度优于对照组（<0.05）。治疗后观察组FEV、用力肺活量（FVC）和6分钟步行距离分别为（1.08±0.11）L、（2.1±0.2）L和（380.34 ± 31.28）m，优于对照组（（0.93±0.09）L、（1.7±0.1）L）和（302.79±29.74）m，差异有统计学意义（<0.05）。观察组患者外周收缩压（PSBP）和外周舒张压（PDBP）水平均低于对照组，差异有统计学意义（<0.05）。
阿奇霉素联合辛伐他汀治疗COPD合并肺动脉高压有确切疗效，可显著缓解通气障碍，改善肺功能，降低肺动脉压，值得临床推广。
