Hasani A, Pavia D, Rotondetto S, Clarke S W, Spiteri M A, Agnew J E
Department of Thoracic Medicine, Royal Free Hospital, London, U.K.
Respir Med. 1998 Mar;92(3):442-7. doi: 10.1016/s0954-6111(98)90289-x.
It has been well established that lung mucociliary clearance is depressed in patients with chronic obstructive pulmonary disease. This study examines whether oral antibiotics have a detectable effect on this clearance mechanism during exacerbation in patients with such disease. Twelve patients with a mean +/- SE age of 63 +/- 2 years participated in a randomized, double-blind, parallel group study to assess the effect of 1 week of treatment with amoxycillin (500 mg t.d.s.) or ciprofloxacin (500 mg b.d.) on lung mucociliary clearance during exacerbation. Lung mucociliary clearance rates were measured by a non-invasive radioaerosol technique. Both drugs on average resulted in small, non-significant, enhancement of mucociliary clearance. Following treatment, the numbers of coughs were reduced in both groups and significantly (P < 0.05) after treatment with ciprofloxacin. Sputum production was also significantly reduced (P < 0.01) in both groups. The magnitude of improvement in lung mucociliary clearance was relatively modest following 1 week of treatment with either antibiotic. Since the number of coughs was significantly less after ciprofloxacin treatment the measured enhancement of lung mucociliary transport is probably, however, an underestimate.
众所周知，慢性阻塞性肺疾病患者的肺黏液纤毛清除功能会降低。本研究旨在探讨口服抗生素对此类疾病患者病情加重期的这种清除机制是否有可检测到的影响。12名平均年龄为63±2岁的患者参与了一项随机、双盲、平行组研究，以评估阿莫西林（500毫克，每日三次）或环丙沙星（500毫克，每日两次）治疗1周对病情加重期肺黏液纤毛清除功能的影响。肺黏液纤毛清除率通过无创放射性气溶胶技术进行测量。两种药物平均都使黏液纤毛清除功能有轻微的、无统计学意义的增强。治疗后，两组的咳嗽次数均减少，环丙沙星治疗后咳嗽次数显著减少（P<0.05）。两组的痰液生成也显著减少（P<0.01）。使用任何一种抗生素治疗1周后，肺黏液纤毛清除功能的改善幅度相对较小。然而，由于环丙沙星治疗后咳嗽次数显著减少，所测得的肺黏液纤毛转运增强可能被低估了。
