上海交通大学学报(医学版)

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瑞舒伐他汀钙对慢性阻塞性肺疾病不同高分辨CT表型的疗效分析

周曦,严峻海,赵春柳,黄卓琼,张柏膺   

  1. 上海交通大学 医学院附属瑞金医院卢湾分院呼吸内科,上海 200020
  • 出版日期:2016-12-28 发布日期:2016-12-29
  • 作者简介:周曦(1979—),男,主治医师,学士;电子信箱:modelmap@139.com。
  • 基金资助:

    上海市卫生和计划生育委员会科研课题(20134161);上海市黄浦区卫生和计划生育委员会2013—2016年度优秀青年人才培养计划配套课题

Analysis of the efficacy of rosuvastatin calcium for different HRCT phenotypes of COPD

ZHOU Xi, YAN Jun-hai, ZHAO Chun-liu, HUANG Zhuo-qiong, ZHANG Bai-ying   

  1. Department of Respiratory Medicine, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
  • Online:2016-12-28 Published:2016-12-29
  • Supported by:

    Research Project of Shanghai Health and Family Planning Commission,20134161;Research on the Training Plan of Excellent Young Talents of Health and Family Planning Commission in Huangpu District of Shanghai from 2013 to 2016

摘要:

目的 ·探讨瑞舒伐他汀钙对慢性阻塞性肺疾病(COPD)不同高分辨CT(HRCT)表型的疗效。方法 ·随机抽取COPD患者50例,通过对HRCT下的不同肺气肿和支气管壁增厚的表现,分成A、E、M 3型。在常规治疗的基础上,予以瑞舒伐他汀钙干预,5 mg/d,为期2年。于治疗开始前行胸部HRCT,进行分型;治疗前后检测患者血浆中的白介素6(IL-6)和白介素8(IL-8),以及肺功能。结果 · 50例COPD患者中,A型10例,E型17例,M型23例。3型患者IL-6、IL-8、用力肺活量(FVC)和第1秒用力呼气容积(FEV1)治疗前后差异均有统计学意义(均P<0.05)。3型间行单因素方差分析,IL-6、IL-8的下降幅度差异均有统计学意义
(P=0.035,P=0.006),A型下降幅度最大;FVC和FEV1的下降幅度差异无统计学意义(P=0.154,P=0.453)。结论 ·瑞舒伐他汀钙对不同HRCT表型的COPD患者的全身炎症反应均有一定疗效,但对肺功能未观察到改善作用;不同表型间疗效有所差异。

关键词: 慢性阻塞性肺疾病, 他汀类药物, 电子计算机X射线断层扫描技术, 白介素6, 白介素8, 肺功能

Abstract:

Objective · To investigate the efficacy of rosuvastatin calcium for different high-resolution CT (HRCT) phenotypes of COPD. Methods · Fifty COPD patients were randomly selected and stratified into 3 types, i.e. A, E, M according to emphysema and bronchial wall thickening using HRCT. Based on conventional treatment, patients received 5 mg/d of rosuvastatin calcium for 2 years. Chest HRCT and type stratification were performed prior to treatment. Plasma IL-6 and IL-8 levels and lung function were measured before and after treatment. Results · There were 10 cases of A type, 17 cases of E type, and 23 cases of M type. Differences in IL-8, IL-6, FVC, and FEV1 before and after treatment between 3 types of patients were statistically significant (P < 0.05). Univariate variance analysis showed that differences in the decrease of IL-6 and IL-8 were statistically significant (P = 0.035, P = 0.006), which in A type patients decreased most. The differences in the decrease of FVC and FEV1 were not statistically significant (P=0.154, P = 0.453). Conclusion · Rosuvastatin calcium had efficacy for systemic inflammatory response in COPD patients with different HRCT phenotypes, but was unable to improve pulmonary function. The efficacy for different phenotypes varied.

Key words: chronic obstructive pulmonary disease, statins, X-ray computer tomography, interleukin-6, interleukin-8, pulmonary function