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目的观察辛伐他汀联合阿奇霉素治疗慢性阻塞性肺疾病(COPD)并肺动脉高压的临床疗效。方法选取2014年9月—2015年12月连云港市东方医院收治的COPD并肺动脉高压患者70例,随机分为对照组和观察组,每组35例。对照组患者口服辛伐他汀片,观察组患者联合口服辛伐他汀片和阿奇霉素片;两组患者均持续治疗6个月。比较两组患者治疗前后肺动脉平均压、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、6分钟步行距离、动脉血氧分压(Pa O2)、血氧饱和度(Sa O2)及C反应蛋白(CRP)水平。结果治疗前两组患者肺动脉平均压、FVC、FEV1比较,差异无统计学意义(P>0.05);治疗后观察组患者肺动脉平均压低于对照组,FVC、FEV1高于对照组(P<0.05)。治疗后两组患者肺动脉平均压均低于治疗前,FVC、FEV1均高于治疗前(P<0.05)。治疗前两组患者6分钟步行距离比较,差异无统计学意义(P>0.05);治疗后观察组患者6分钟步行距离长于对照组(P<0.05)。治疗后两组患者6分钟步行距离均长于治疗前(P<0.05)。治疗前两组患者Pa O2、Sa O2比较,差异无统计学意义(P>0.05);治疗后观察组患者Pa O2、Sa O2高于对照组(P<0.05)。治疗后两组患者Pa O2、Sa O2均高于治疗前(P<0.05)。治疗前两组患者CRP水平比较,差异无统计学意义(P>0.05);治疗后观察组CRP水平低于对照组(P<0.05)。治疗后两组患者CRP水平均低于治疗前(P<0.05)。结论辛伐他汀联合阿奇霉素治疗COPD并肺动脉高压的临床疗效确切,可有效改善患者肺功能、降低肺动脉压,同时降低CRP水平。
Objective To observe the clinical efficacy of simvastatin combined with azithromycin in the treatment of chronic obstructive pulmonary disease (COPD) and pulmonary hypertension. Methods Seventy patients with COPD and pulmonary hypertension who were admitted to Lianyungang Dongfang Hospital from September 2014 to December 2015 were randomly divided into control group and observation group with 35 cases in each group. The patients in the control group received simvastatin tablets orally and the patients in the observation group received simvastatin tablets and azithromycin tablets orally. Patients in both groups were treated for 6 months. The mean pulmonary artery pressure, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), walking distance of 6 minutes, Pa O2 and Sa O2 were compared between the two groups before and after treatment. And C-reactive protein (CRP) levels. Results Before treatment, the average pulmonary artery pressure, FVC and FEV1 in the two groups were not significantly different (P> 0.05). After treatment, the average pulmonary artery pressure in the observation group was lower than that in the control group, and the FVC and FEV1 were higher than those in the control group (P <0.05) . After treatment, the average pulmonary artery pressure in both groups was lower than before treatment, and FVC and FEV1 were higher than before treatment (P <0.05). There was no significant difference in the 6-minute walk distance between the two groups before treatment (P> 0.05). After 6-minute walking distance, the observation group was longer than the control group (P <0.05). After 6 minutes of treatment, both groups walk longer than before treatment (P <0.05). There was no significant difference in Pa O2 and Sa O2 between the two groups before treatment (P> 0.05). PaO2 and Sa O2 in the observation group were higher than those in the control group after treatment (P <0.05). After treatment, the Pa O2 and Sa O2 in both groups were higher than those before treatment (P <0.05). There was no significant difference in CRP level between the two groups before treatment (P> 0.05). After treatment, CRP level in the observation group was lower than that in the control group (P <0.05). CRP levels in both groups after treatment were lower than before treatment (P <0.05). Conclusion Simvastatin combined with azithromycin in the treatment of COPD and pulmonary hypertension has definite curative effect, which can effectively improve pulmonary function, decrease pulmonary arterial pressure and reduce CRP level.