中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
7期
695-698
,共4页
陈兴无%张丽琴%涂雄文%谢家政
陳興無%張麗琴%塗雄文%謝傢政
진흥무%장려금%도웅문%사가정
慢性阻塞性肺疾病%辛伐他汀%炎症%SNOT-20评分%SGRQ评分
慢性阻塞性肺疾病%辛伐他汀%炎癥%SNOT-20評分%SGRQ評分
만성조새성폐질병%신벌타정%염증%SNOT-20평분%SGRQ평분
Chronic obstructive pulmonary disease%Simvastatin%Inflammation%Sino-Nasal outcome test-20%St George's Respiratory Questionnaire
目的 探讨辛伐他汀对慢性阻塞性肺疾病(COPD)患者鼻灌洗液、痰液和血清中炎症细胞和(或)炎症递质与临床指标的影响.方法 选择COPD缓解期患者37例,给予常规治疗20例,辛伐他汀40mg/d治疗17例,比较治疗前和治疗4周患者鼻灌洗液和痰中细胞数、中性粒细胞百分比(N%)和IL-8、IL-6浓度,检测血清CRP、IL-8、IL-6及TC和LDL-C浓度,并观察肺功能、生活质量评分(SNOT-20)、呼吸问卷(SGRQ)评分的变化.结果 4周后辛伐他汀组鼻灌洗液和痰中细胞总数、N%、IL-8、IL-6[鼻灌洗液:(0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5)ng/L,(3.8±1.6)ng/L;痰:(0.8±0.3)×109/L,(56.6±9.6)%,(2565.5±831.9)ng/L,(109.8±42.3)ng/L]较治疗前[鼻灌洗液:(0.8±0.3)×107/L、(43.2±10.8)%、(107.6±86.3)ng/L、(4.1±1.9)ng/L;痰:(0.8±0.3)×109/L、(58.1±9.3)%、(2659.4±885.2)ng/L、(111.8±46.6)ng/L]轻度降低,但差异无统计学意义(P均>0.05);血清CRP、IL-6和TC、LDL-C水平显著减低[治疗前分别为(4.3±3.7)mg/L、(4.8±2.0)ng/L、(4.2±1.0)mmol/L、(2.4±0.5)mmoL/L;治疗后分别为(2.6±1.8)mg/L、(4.7±1.9)ng/L、(3.7±0.8)mmol/L、(2.2±0.5)mmol/L,P均<0.05],IL-8浓度轻度降低[(6.2±1.8)ng/L与(6.4±1.9)ng/L],但差异无统计学意义(P>0.05);SGRQ各项分值中症状评分明显减低[(39.6±10.8)分与(32.3±11.6)分,P<0.05],其他观察项目(SNOT-20量表评分、肺功能)改善不明显(P均>0.05).常规治疗组所有炎症指标及生活质量评分、肺功能均无显著改善(P均>0.05).结论 辛伐他汀可减轻COPD患者全身性炎症反应并缓解症状.
目的 探討辛伐他汀對慢性阻塞性肺疾病(COPD)患者鼻灌洗液、痰液和血清中炎癥細胞和(或)炎癥遞質與臨床指標的影響.方法 選擇COPD緩解期患者37例,給予常規治療20例,辛伐他汀40mg/d治療17例,比較治療前和治療4週患者鼻灌洗液和痰中細胞數、中性粒細胞百分比(N%)和IL-8、IL-6濃度,檢測血清CRP、IL-8、IL-6及TC和LDL-C濃度,併觀察肺功能、生活質量評分(SNOT-20)、呼吸問捲(SGRQ)評分的變化.結果 4週後辛伐他汀組鼻灌洗液和痰中細胞總數、N%、IL-8、IL-6[鼻灌洗液:(0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5)ng/L,(3.8±1.6)ng/L;痰:(0.8±0.3)×109/L,(56.6±9.6)%,(2565.5±831.9)ng/L,(109.8±42.3)ng/L]較治療前[鼻灌洗液:(0.8±0.3)×107/L、(43.2±10.8)%、(107.6±86.3)ng/L、(4.1±1.9)ng/L;痰:(0.8±0.3)×109/L、(58.1±9.3)%、(2659.4±885.2)ng/L、(111.8±46.6)ng/L]輕度降低,但差異無統計學意義(P均>0.05);血清CRP、IL-6和TC、LDL-C水平顯著減低[治療前分彆為(4.3±3.7)mg/L、(4.8±2.0)ng/L、(4.2±1.0)mmol/L、(2.4±0.5)mmoL/L;治療後分彆為(2.6±1.8)mg/L、(4.7±1.9)ng/L、(3.7±0.8)mmol/L、(2.2±0.5)mmol/L,P均<0.05],IL-8濃度輕度降低[(6.2±1.8)ng/L與(6.4±1.9)ng/L],但差異無統計學意義(P>0.05);SGRQ各項分值中癥狀評分明顯減低[(39.6±10.8)分與(32.3±11.6)分,P<0.05],其他觀察項目(SNOT-20量錶評分、肺功能)改善不明顯(P均>0.05).常規治療組所有炎癥指標及生活質量評分、肺功能均無顯著改善(P均>0.05).結論 辛伐他汀可減輕COPD患者全身性炎癥反應併緩解癥狀.
목적 탐토신벌타정대만성조새성폐질병(COPD)환자비관세액、담액화혈청중염증세포화(혹)염증체질여림상지표적영향.방법 선택COPD완해기환자37례,급여상규치료20례,신벌타정40mg/d치료17례,비교치료전화치료4주환자비관세액화담중세포수、중성립세포백분비(N%)화IL-8、IL-6농도,검측혈청CRP、IL-8、IL-6급TC화LDL-C농도,병관찰폐공능、생활질량평분(SNOT-20)、호흡문권(SGRQ)평분적변화.결과 4주후신벌타정조비관세액화담중세포총수、N%、IL-8、IL-6[비관세액:(0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5)ng/L,(3.8±1.6)ng/L;담:(0.8±0.3)×109/L,(56.6±9.6)%,(2565.5±831.9)ng/L,(109.8±42.3)ng/L]교치료전[비관세액:(0.8±0.3)×107/L、(43.2±10.8)%、(107.6±86.3)ng/L、(4.1±1.9)ng/L;담:(0.8±0.3)×109/L、(58.1±9.3)%、(2659.4±885.2)ng/L、(111.8±46.6)ng/L]경도강저,단차이무통계학의의(P균>0.05);혈청CRP、IL-6화TC、LDL-C수평현저감저[치료전분별위(4.3±3.7)mg/L、(4.8±2.0)ng/L、(4.2±1.0)mmol/L、(2.4±0.5)mmoL/L;치료후분별위(2.6±1.8)mg/L、(4.7±1.9)ng/L、(3.7±0.8)mmol/L、(2.2±0.5)mmol/L,P균<0.05],IL-8농도경도강저[(6.2±1.8)ng/L여(6.4±1.9)ng/L],단차이무통계학의의(P>0.05);SGRQ각항분치중증상평분명현감저[(39.6±10.8)분여(32.3±11.6)분,P<0.05],기타관찰항목(SNOT-20량표평분、폐공능)개선불명현(P균>0.05).상규치료조소유염증지표급생활질량평분、폐공능균무현저개선(P균>0.05).결론 신벌타정가감경COPD환자전신성염증반응병완해증상.
Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.
