辛伐他汀联合运动训练对慢性阻塞性肺疾病稳定期合并代谢综合征患者临床观察

目的:观察辛伐他汀联合运动训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期合并代谢综合征患者作用。方法:选取120例COPD稳定期合并代谢综合征(metabolism syndrome,MS)为研究对象,随机分为治疗A组、治疗B组及对照组各40例。治疗A组在常规治疗基础上加用辛伐他汀联合运动训练,治疗B组在常规治疗基础上加用辛伐他汀,对照组仅给予常规治疗,观察期为6个月。比较3组患者血清细胞因子白细胞介质(interleukin,IL)-6、IL-8与肿瘤坏死因子-α(tumor necrosis factor,TNF-α),胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA),脉搏波速度(pulse wave velocity,PWV),mMRC及6 min步行距离(6 minutes walking distance ,6MWD),并对所获结果进行统计学分析。结果:6个月治疗后:(1)治疗A组及治疗B组的血炎症因子IL-6、IL-8与TNF-α较治疗前及对照组均明显下降,差异有统计学意义(P<0.01);治疗组2组之间比较,A组较B组有明显下降,差异有统计学意义(P<0.05);(2)治疗A组与治疗B组、对照组比较,HOMA有明显下降,差异有统计学意义(P<0.05),但治疗B组与对照组比较,无明显差异(P>0.05);(3)治疗A组、B组与对照组比较,PWV值有明显下降,差异有统计学意义(P<0.05);治疗组2组之间比较,A组较B组PWV值下降,但无明显差异(P>0.05);(4)治疗A组与治疗B组、对照组比较,mMRC及6MWD均明显改善,差异有统计学意义(P<0.05);治疗B组较对照组比较,mMRC及6MWD均明显改善,差异有统计学意义(P<0.05)。结论:辛伐他汀联合运动训练能降低COPD稳定期合并MS的 IL-6、IL-8、TNF-α水平;改善胰岛素抵抗及大动脉弹性,并改善患者呼吸困难程度及运动能力。

Clinical observation of effects of simvastatin combined exercise training in patients during stable period of chronic obstructive pulmonary disease and with metabolic syndrome

OBJECTIVE To observe the effects of simvastatin combined exercise training in patients during stable period of chronic obstructive pulmonary disease (COPD) and with metabolic syndrome.METHODS A total of 120 patients with metabolic syndrome combined with stable COPD were randomly divided into group A, group B and control group, 40 patients in each group. Besides of conventional therapy, group A adopted simvastatin combined exercise training, group B adopted simvastatin alone. The control group only received conventional therapy. The patients were observed for six months. Patients of three groups were compared for serum cytokines including interleukin (IL) -6, IL-8 and tumor necrosis factor-α (TNF-α), insulin resistance index (HOMA-IR), pulse wave velocity (PWV), mMRC and 6-minute walking distance (6MWD). The results were analyzed statistically.RESULTS After six months of therapy, IL-6, IL-8 and TNF-α in group A and B were significantly decreased compared with control group (P<0.01); in group A were decreased significantly compared with group B (P<0.05). HOMA in group A group was significant decreased compared with group B and control group (P<0.05), but difference between group B and control group was not significant (P>0.05). PWV was decreased significantly in group A and B compared with control group (P<0.05), but no significant difference was observed between group A and group B (P>0.05). mMRC and 6MWD were significantly improved in group A than in group B (P<0.05), and also with significant difference between group B and control group (P<0.05). CONCLUSION In MS patients with stable COPD, simvastatin combined exercise training can reduce IL-6, IL-8 and TNF-α levels, improve insulin resistance and arterial elasticity, alleviate dyspnea and increase exercise capacity.