口服罗红霉素对慢性阻塞性肺疾病患者肺功能的影响

目的探讨口服罗红霉素对慢性阻塞性肺疾病（COPD）患者肺功能的影响，并分析其可能的机制。方法将50例COPD患者采用随机、单盲方法分成治疗组25例与对照组25例，其中对照组采用常规基础治疗，治疗组在常规基础治疗基础上口服罗红霉素0．15g，2次／d，并持续1年。观察两组患者治疗前后外周血中性粒细胞计数及肺功能的变化，统计分析两组患者发生病情急性加重及因此而需住院的次数。结果治疗组患者治疗前后外周血中性粒细胞计数差异有统计学意义（P〈0．05）；治疗组第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1％预计值）、最大通气量、清晨最大呼气流量治疗前后改变不明显（P〉0．05），对照组却有明显下降（P〈0．05），两组患者治疗前后肺功能的变化差异有统计学意义（P〈0.05）；治疗组急性加重10例次（40％），对照组19例次（76％）；治疗组需住院6例次（24％），对照组13例次（52％），两组急性加重率及需住院率比较差异均有统计学意义（P〈0．05）。结论口服罗红霉素对COPD患者肺功能具有保护作用，其可能的机制与罗红霉素对中性粒细胞的抑制作用有关。

The protective effect of oral roxithromycin on lung function in chronic obstructive pulmonary disease

Objective To evaluate the effect of oral roxithromycin on lung function in chronic obstructive pulmonary disease （COPD） and analyse the probable mechanism. Methods Fifty patients with COPD were divided randomly into treatment group （25 cases） and control group （25 cases）. The control group was treated with base therapy, and the treatment group was treated with oral roxithromycin beside base therapy, 0.15 g, twice one day for one year. Then the changes of peripheral blood neutrophil and lung function was observed before and after treatment, and the times of acute exacerbation were statistically analyzed. Results There was significant difference in the changes of peripheral blood neutrophil in treatment group （P 〈 0.05）. The ratio of forced expiratory volume in one second and forced vital capacity （FEVJFVC）, FEVI% pred, peak expiratory flow, maximal vital volume had no obvious change in treatment group （P 〉 0.05 ）, but had obvious decrease in control group （P〈 0.05 ）. There was significant difference in the changes of lung function in two groups（P 〈 0.05 ）. The times of acute exacerbation were 10（40% ） in treatment group and 19 （76%） in control group, and the times of need to be in hospital were 6 （24%） and 13 （52%） respectively. There were significant difference （P 〈 0.05）. Conclusion Long-term oral roxithromycin can protect the lung function of COPD patients, the probable mechanism is that roxithromycin inhibit the neutrophil＇s function.