论文部分内容阅读
目的评价长期口服小剂量罗红霉素对稳定期慢性阻塞性肺疾病(COPD)急性加重频率、肺功能、血清C反应蛋白和痰中病原菌的影响。方法稳定期COPD患者100例中,随机分为治疗组50例(给予罗红霉素150mg,每日1次口服)和对照组50例。两组允许吸氧、口服稳定剂量的茶碱、吸入支气管扩张剂和吸入糖皮质激素。疗程6个月。记录研究期间患者发生COPD急性加重的频率和程度,测量入选时和结束时肺功能第1s用力呼气容积占预计值百分比(FEV1占预计值%)、血清C反应蛋白和观察期间的痰培养。结果 92例患者完成研究,共发生COPD急性加重90人次,治疗组28人次,对照组62人次,差别有统计学意义(P<0.01);治疗组7人发生2次以上急性加重,对照组17人,差别有统计学意义(P<0.05);治疗组严重急性发作6人次,对照组12人次,差别无统计学意义。FEV1占预计值%在发生COPD急性加重的患者([48.8±12.0)%]比没有发生急性加重者([56.3±12.6)%]更低(P<0.05)。治疗组在治疗前、后FEV1占预计值%分别为(54.3±12.4)%和(53.7±13.1)%,血清C反应蛋白分别为5.1(2.9,6.8)mg/L和4.5(3.0,7.0)mg/L,较对照组无改善,两组痰培养在细菌分布和耐药性方面差别无统计学意义。结论长期小剂量罗红霉素可以减少稳定期COPD患者急性加重频率。
Objective To evaluate the effect of long-term oral low dose roxithromycin on the acute exacerbation of chronic obstructive pulmonary disease (COPD), lung function, serum C-reactive protein and pathogens in sputum. Methods A total of 100 patients with stable COPD were randomly divided into treatment group (50 cases) and control group (50 cases, 150 mg roxithromycin daily). Both groups allowed inhaled oxygen, a stable oral dose of theophylline, inhaled bronchodilators, and inhaled corticosteroids. Course of 6 months. The frequency and extent of acute exacerbations of COPD were recorded during the study period. The forced expiratory volume of 1 s of pulmonary function at the time of enrollment and at the end was recorded as a percentage of expected value (% predicted FEV1), serum C-reactive protein and sputum culture during the observation period. Results 92 patients completed the study, a total of 90 patients with acute exacerbation of COPD, 28 patients in the treatment group, 62 patients in the control group, the difference was statistically significant (P <0.01); 7 patients in the treatment group more than 2 times acute exacerbations, the control group 17 Person, the difference was statistically significant (P <0.05); treatment group severe acute attack of 6 people, control group of 12 people, the difference was not statistically significant. Predict% FEV1 was lower (P <0.05) in patients experiencing an exacerbation of COPD ([48.8 ± 12.0]%] than those without exacerbation (56.3 ± 12.6%). The pre-treatment and post-treatment FEV1 accounted for (54.3 ± 12.4)% and (53.7 ± 13.1)% of the expected value of the treatment group, 5.1 (2.9,6.8) mg / L and 4.5 (3.0,7.0) mg / L, no improvement compared with the control group. There was no significant difference in bacterial distribution and drug resistance between the two groups in sputum culture. Conclusion Long-term low-dose roxithromycin can reduce the frequency of acute exacerbations in patients with stable COPD.