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目的研究长期小剂量阿奇霉素治疗对慢性阻塞性肺疾病(COPD)是否有疗效。方法选择稳定期COPD病人65例,随机分成两组,治疗组口服阿奇霉素0.25g,每日1次,连续用药6周。对照组不用任何药。两组病人在病情加重时,临时应用茁-内酰胺类抗生素。治疗前、治疗6周后检测肺功能1s用力呼气容积(FEV1)和血浆白细胞介素(IL)-6、IL-8及肿瘤坏死因子(TNF)-琢的浓度,并记录临床症状记分。结果60例完成了试验,治疗组30例临床症状改善[治疗前(4.1±0.4)分,治疗后(3.8±0.5)分,P<0.01];FEV1也有改善[治疗前(1.68±0.23)L,治疗后(1.72±0.21)L,P<0.05];血浆IL-8浓度[治疗前(8.5±2.6)pg/ml,治疗后(8.5±2.6)pg/ml]、IL-6浓度[治疗后(7.1±2.8)pg/ml,治疗后(7.0±2.8)pg/ml]及TNF-琢浓度[治疗前(7.6±2.7)pg/ml,治疗后(7.5±2.7)pg/ml]均无明显改变(P>0.05)。对照组(30例)治疗前后各项指标差异无显著性(P>0.05),治疗期间未再见明显副作用。结论长期小剂量阿奇霉素治疗COPD患者可改善临床症状和其肺功能,且安全性好,不影响对血浆IL-8、IL-6及TNF-琢的浓度。
Objective To investigate whether long-term, low-dose azithromycin can be effective in treating chronic obstructive pulmonary disease (COPD). Methods Sixty-five patients with stable COPD were randomly divided into two groups. The treatment group received azithromycin 0.25 g once daily for 6 weeks. The control group did not need any medicine. Two groups of patients in aggravating illness, the temporary application of Zhuo - lactam antibiotics. Before treatment, 6 weeks after treatment, forced expiratory volume (FEV1), plasma interleukin (IL) -6, IL-8 and tumor necrosis factor (TNF) Results 60 patients completed the trial, the treatment group, 30 patients improved clinical symptoms [before treatment (4.1 ± 0.4) points after treatment (3.8 ± 0.5) points, P <0.01]; FEV1 also improved [before treatment (1.68 ± 0.23) L , After treatment (1.72 ± 0.21) L, P <0.05]; The plasma IL-8 concentration (8.5 ± 2.6 pg / ml before treatment and 8.5 ± 2.6 pg / ml after treatment] (7.1 ± 2.8) pg / ml post-treatment (7.0 ± 2.8) pg / ml] and TNF- No significant change (P> 0.05). The control group (30 cases) before and after treatment there was no significant difference between the various indicators (P> 0.05), did not see the obvious side effects during treatment. Conclusion Long-term low-dose azithromycin in patients with COPD can improve clinical symptoms and lung function, and good safety, does not affect the concentration of plasma IL-8, IL-6 and TNF-.