上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

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

PDF (PC)

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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