不同剂量辛伐他汀治疗慢性阻塞性肺疾病急性加重的效果

doi:10.3969/j.issn.2095-9400.2019.11.011

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摘要目的：探讨不同剂量辛伐他汀治疗慢性阻塞性肺疾病（简称慢阻肺）急性加重期患者的疗效和安全性。方法：180例慢阻肺急性加重期患者随机分为常规剂量辛伐他汀（40 mg/d）治疗组（A组）、低剂量辛伐他汀（20 mg/d）治疗组（B组）、常规治疗对照组（C组）。主要指标为C-反应蛋白（CRP）；次要指标包括白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、动脉血气、肺功能、6 min步行试验。结果：180例患者进入随机分组，3例患者脱落。与治疗前比较，各组患者治疗后炎症指标（CRP、IL-6、TNF-α）均明显下降（P＜0.01）；与C组比较，A组和B组治疗后炎症指标均较低（P＜0.05）；与B组比较，A组炎症指标均较低（P＜0.05）。与治疗前比较，各组患者治疗后动脉血气、肺功能、6 min步行试验均改善（P＜0.01），3组间上述指标差异均无统计学意义（P＞0.05）。结论：辛伐他汀可以抑制慢阻肺急性加重期患者全身炎症反应，尤以常规剂量辛伐他汀明显。

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	池琼
	郑纪阳
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关键词 ：辛伐他汀；慢性阻塞性肺疾病急性加重期；C-反应蛋白；白介素-6；肿瘤坏死因子-&alpha

Abstract：Objective: To investigate the efficacy and safety of different doses of simvastatin in the treatment of patients with chronic obstructive pulmonary disease (COPD) at acute exacerbation stage. Methods: Totally 180 patients with acute exacerbation of COPD were randomly divided as the conventional simvastatin (40 mg/d)
treatment group (group A), the low-dose simvastatin (20 mg/d) treatment group (group B), and the conventional treatment control group (group C). The primary indicator was C-reactive protein (CRP) and the secondary indicators included interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), arterial blood gas, lung function, a 6-minute walk test (6MWD). Results: 180 patients entered the randomized group and three of them fell off. Compared with the situation before treatment, the above inflammation indicators, including CRP, IL-6 and TNF-α decreased significantly after treatment (P<0.01), and they were significantly lower in group A and group B (P<0.05) than group C, with group A the lowest (P<0.05). The arterial blood gas, lung function and 6MWD index of each group were improved (P<0.01), and no significant difference was found between the three groups after treatment (P>0.05). Conclusion: Simvastatin, especially the conventional doses of simvastatin, can inhibit patients with COPD from systemic inflammatory response at acute exacerbation stage.

Key words： simvastatin acute exacerbation, chronic obstructive pulmonary disease C-reactive protein interleukin-6 tumor necrosis factor-alpha

收稿日期: 2019-04-17

基金资助:浙江省医药卫生科技计划项目（2015KYB365）。

通讯作者: 郑纪阳，主任医师，Email：drzheng6562@163.com。

作者简介: 池琼（1977-），女，浙江瑞安人，副主任医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2019.11.011 或 https://xb.wmu.edu.cn/CN/Y2019/V49/I11/842

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