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目的:观察罗红霉素对慢性阻塞性肺疾病(COPD)稳定期患者气道炎症的疗效,为COPD稳定期治疗提供依据。方法:COPD稳定期门诊患者46例分为观察组和对照组。对照组给予常规治疗,观察组在对照组基础上加用罗红霉素软胶囊150 mg·d-1,均治疗10个月。比较两组患者痰液和血清中γ-IFN、IL-8和TNF-α等细胞因子水平,以及痰液中白细胞、中性粒细胞计数的变化,观察两组药品不良反应发生情况。结果:用药5个月时,观察组患者血清和痰液中的γ-IFN、IL-8和TNF-α等细胞因子水平均较用药前明显下降(P<0.05),痰中白细胞、中性粒细胞计数较用药前明显下降(P<0.05),且上述指标均明显低于对照组(P<0.05);用药10个月时,观察组患者上述指标较用药5个月时又有明显下降(P<0.05),且均显著低于对照组(P<0.05)。观察组仅发生1例药品不良反应,患者退出研究。结论:长期服用小剂量罗红霉素可以降低COPD稳定期患者痰液和血清中的细胞因子,以及痰液中炎症细胞计数,对气道炎症有一定的抑制作用。
Objective: To observe the effect of roxithromycin on airway inflammation in patients with chronic obstructive pulmonary disease (COPD) and to provide basis for stable COPD treatment. Methods: Forty-six outpatients with stable COPD were divided into observation group and control group. The control group was given routine treatment. The observation group was given roxithromycin 150 mg · d-1 on the basis of the control group for 10 months. The levels of cytokines such as γ-IFN, IL-8 and TNF-α in sputum and serum were compared between the two groups. The changes of leukocyte and neutrophil count in sputum were also observed. Adverse reactions were observed in two groups. Results: At 5 months after treatment, the levels of cytokines such as γ-IFN, IL-8 and TNF-α in serum and sputum of observation group were significantly lower than those before treatment (P <0.05) (P <0.05), and the above indexes were significantly lower than those of the control group (P <0.05). At 10 months after treatment, the above indexes in the observation group were significantly lower than those at 5 months (P <0.05), which were significantly lower than those in the control group (P <0.05). Only one case of adverse drug reactions occurred in the observation group and the patient was withdrawn from the study. CONCLUSION: Long-term administration of low dose roxithromycin can reduce cytokines in sputum and serum in patients with stable COPD, as well as inflammatory cell counts in sputum, which may have some inhibitory effects on airway inflammation.