阿奇霉素治疗不同CT表型稳定期COPD患者的临床研究

目的:研究阿奇霉素维持治疗对不同高分辨率CT(HRCT)表型稳定期慢性阻塞性肺疾病(COPD)患者急性加重频次、肺功能的影响。方法:本研究为前瞻性、随机、双盲、安慰剂对照、单中心临床试验。选取2013年5月至2018年5月于河北中石油中心医院呼吸与危重症医学科住院或门诊治疗好转的COPD稳定期患者110例进行研究。11...

Clinical research of azithromycin on different computer tomography phenotype of stable COPD

Objective To investigate the clinical significance of azithromycin maintenance therapy on chronic obstructive pulmonary disease(COPD)with different high resolution computer tomography(HRCT)phenotypes.Methods This study was a prospective,randomized,double-blind,placebo-controlled,single-center clinical trial participants with stable,frequent exacerbations and GOLD≥2 grade were divided into azithromycin group(n=58)and placebo group(n=52)randomly.Subjects were randomly given azithromycin(500 mg,three times per week,for 1 year)or placebo(500 mg,three times per week,for 1 year)on the usual care.At the same time participants were classified into three phenotypes by HRCT type A(n=39),type E(n=38),type M(n=33).The differences of the frequency rate of acute exacerbations,lung function between the three phenotypes after azithromycin maintenance therapy were compared.Results(1)The frequency rate of AECOPD per-person yearly between azithromycin group and the placebo group,media time to first acute exacerbation and the forced expiratory volume in one second(FEV1)declines were different significantly(Z=-4.28,χ²=6.53,t=12.73,all P<0.05).(2)The frequency rate of AECOPD per-person yearly between azithromycin group and the placebo group in phenotype M,media time to first acute exacerbation and the FEV1 declines were different significantly(Z=-3.43,χ²=13.69,t=21.56,all P<0.05).There were no significant differences in the frequency rate of acute exacerbations and media time to first acute exacerbation between phenotype A and E(both P>0.05).Conclusions Azithromycin maintenance therapy can reduce the frequency rate of acute exacerbations,prolong the time to first exacerbation,lower the declines of FEV1 in stable COPD participants.The therapeutic efficacy is obvious in M phenotype of HRCT.