CAJ | 학술논문

目的观察阿托伐他汀对各级稳定期慢性阻塞性肺疾病(COPD)患者的治疗效果,探讨他汀类药物治疗COPD的时机.方法选择2012年2月至2013年5月本院门诊或住院COPD治疗后进入稳定期的患者为研究对象,Ⅰ级～Ⅳ级稳定期COPD患者各40例,每级患者按随机数字表法分为常规治疗组(对照组)和阿托伐他汀组(治疗组),每组20例.常规治疗组中Ⅰ级患者按需吸入沙丁胺醇气雾剂,Ⅱ级患者在Ⅰ级患者治疗基础上规律使用一种或多种长效支气管扩张剂,Ⅲ级及Ⅳ级患者如反复出现急性加重,则在Ⅱ级患者治疗基础上加用沙美特罗/氟替卡松,Ⅳ级患者伴慢性呼吸衰竭者予家庭氧疗.阿托伐他汀组在常规治疗的基础上加用阿托伐他汛20 mg/粒,辉瑞药制有限公司)1粒,每晚睡前服用.结果 Ⅰ～Ⅳ级治疗组患者肺功能指标(FEV1)下降幅度分别是(23±10) ml、(12±7) ml、(9±5) ml、(4±3) ml,对照组患者肺功能指标(FEV1)下降幅度分别是(60±21) ml、(50±15) ml、(45±12)ml、(20±8) ml,同级治疗组与对照组FEV1下降值比较差异有统计学意义(P＜0.05).各级对照组6 min步行距离(6MWD)减少,COPD评估测试(ACT)评分增加,急性加重次数增加;治疗组6MWD、ACT评分、急性加重次数较治疗前均有改善.同级治疗组与对照组以上三项指标比较差异均有统计学意义(P＜0.05).结论阿托伐他汀可减缓各级COPD患者肺功能下降速度、改善生命质量、减少急性加重次数,早期用药有利于改善病程.
목적 관찰아탁벌타정대각급은정기만성조새성폐질병(COPD)환자적치료효과,탐토타정류약물치료COPD적시궤.방법 선택2012년2월지2013년5월본원문진혹주원COPD치료후진입은정기적환자위연구대상,Ⅰ급～Ⅳ급은정기COPD환자각40례,매급환자안수궤수자표법분위상규치료조(대조조)화아탁벌타정조(치료조),매조20례.상규치료조중Ⅰ급환자안수흡입사정알순기무제,Ⅱ급환자재Ⅰ급환자치료기출상규률사용일충혹다충장효지기관확장제,Ⅲ급급Ⅳ급환자여반복출현급성가중,칙재Ⅱ급환자치료기출상가용사미특라/불체잡송,Ⅳ급환자반만성호흡쇠갈자여가정양료.아탁벌타정조재상규치료적기출상가용아탁벌타신20 mg/립,휘서약제유한공사)1립,매만수전복용.결과 Ⅰ～Ⅳ급치료조환자폐공능지표(FEV1)하강폭도분별시(23±10) ml、(12±7) ml、(9±5) ml、(4±3) ml,대조조환자폐공능지표(FEV1)하강폭도분별시(60±21) ml、(50±15) ml、(45±12)ml、(20±8) ml,동급치료조여대조조FEV1하강치비교차이유통계학의의(P＜0.05).각급대조조6 min보행거리(6MWD)감소,COPD평고측시(ACT)평분증가,급성가중차수증가;치료조6MWD、ACT평분、급성가중차수교치료전균유개선.동급치료조여대조조이상삼항지표비교차이균유통계학의의(P＜0.05).결론 아탁벌타정가감완각급COPD환자폐공능하강속도、개선생명질량、감소급성가중차수,조기용약유리우개선병정.
Objective To observe the treatment efficacy of atorvastatin for patients with different severities of chronic obstructive pulmonary disease (COPD) in stable stage.To investigate the timing of statin therapy for COPD.Methods Out-patients and inpatients with COPD got into stable stage being treated at our hospital from February to May,2013 were chosen as study objects.There were 40 cases in each severity degree of Ⅰ-Ⅳ.Patients of each degree were randomly divided into conventional treatment groups (control groups) and atorvastatin groups (treatment groups),with 20 for each group.The control group of degree Ⅰ inhaled albuterol aerosol when needed; in addition,the one of degree Ⅱ regularly took one or more long-acting bronchodilators; the ones of degree Ⅲ and Ⅳ took salmeterol / fluticasone basing on the treatment of the one of degree Ⅱ if repeatedly occurring acute exacerbations; patients of degree Ⅳ were treated with home oxygen therapy if they had chronic respiratory failure.In addition,the atorvastatin groups took 20 mg atorvastatin (20mg / tablet,by Pfizer Ltd) every night at bedtime.Results The lung function (FEV1) decreased (23 ± 10) ml,(12 ± 7) ml,(9 ± 5) ml,and (4 ± 3) ml in the treatment groups and (60 ± 21) ml,(50 ± 15) ml,(45 ± 12) ml,and (20 ± 8) ml in the control groups of degree Ⅰ-Ⅳ,respectively,with statistical differences between the control groups and treatment groups of the same degree(P ＜ 0.05).6 min walk test (6MWT) decreased,COPD Assessment Test (ACT) score increased,and the occurring frequency of acute exacerbations increased in all the control groups; 6MWT,COPD Assessment Test (ACT) score,and the occurring frequency of acute exacerbations were better compared with those before the treatment in all the treatment groups; there were statistical differences in the three indicators between the control groups and treatment groups of the same degree (P ＜ 0.05).Conclusions Atorvastatin can slow down the declining rate of the pulmonary function,improve the quality of life,and reduce the occurring frequency of acute exacerbations of patients with COPD of all degrees.Early treatment will help improve the course.