慢性阻塞性肺疾病稳定期辛伐他汀与炎症反应关系的研究

目的：探讨辛伐他汀对慢性阻塞性肺疾病（COPD）患者鼻灌洗液、痰液和血清中炎症细胞和（或）炎症递质与临床指标的影响。方法：选择COPD缓解期患者44例，给予常规治疗20例，辛伐他汀40mg／d治疗24例，比较治疗前和治疗10周后患者血清中IL-8、IL-6、CRP、VEGF浓度，并观察肺功能、临床症状评分及呼吸问卷（SGRQ）评分的变化。结果：10周后辛伐他汀组血清中IL-8（6．0±2．3）ng／L]较治疗前（6．9±1．9）ng／L1轻度降低，VEGF（687．9±30．2）ng／Lvs（650．8±32．2）ng／L]轻度升高，但差异无统计学意义（P均〉0．05）；血清中CRP、IL-6水平显著减低治疗前分别为（4．2±3．6）mg／L、（4．7±1．7）ng／L；治疗后分别为（2．2±2．0）mg／L、（4-3±1．8）ng／L1，差异有统计学意义（P〈0．05）；临床症状评分和SGRQ各项分值中症状评分明显减低（3．9±1．0）VS（3．2±0．9）；（28．7±11．4）vs（27．9±10．2）1，差异有统计学意义（P〈0．05），肺功能改善不明显（P均〉0．05）。常规治疗组所有炎症指标及生活质量评分、肺功能均无显著改善（P均〉0．05）。结论：辛伐他汀可减轻COPD患者全身性炎症反应并缓解症状。

Effects of simvastatin on inflammation in patients with chronic obstructive pulmonary diseases

Objective： To investigate the nature of simvastatin on chronic obstructive pulmonary disease （COPD） patients with nasal lavage, sputum and serum inflammatory cells and （or） inflammation and clinical indices of neurotransmitter. Methods： 44 palients with COPD in remission, 20 patients received conventional treatment with simvastafin 40 mg/d treatment of 24 patients compared 10 weeks before treatment and after treatment of serum IL-8, IL-6, CRP, VEGF levels and to observe the lung function, clinical symptoms and respiratory questionnaire （SGRQ） score changes. Results： After 10 weeks of simvastatin in serum IL-8 （6.0±2.3） ng/L] than before treatment （6.9±1.9） ng/L] slightly decreased, VEGF （687.9±30.2） ng/L vs （650.8±32.2） ng/L] slightly elevated, but the difference was not statistically significant （all P〉0.05）; serum CRP, IL-6 levels were significantly reduced before treatment were （4.2±3.6） mg/L, （4.7±1.7） ng/L; treatment were （2.2±2.0） mg/L, （4.3±1.8） ng/L], the difference was statistically significant （P〈0.05）; Clinical score and the SGRQ scores in the symptom score was significantly lower （3.9±.0） vs （3.2±.9）; （28.7±1.4） vs （27.9±10.2）], the difference was statistically significant （P〈0.05）, no obvious improvement in lung function （all P〉0.05）. Conventional treatment group, all inflammatory markers and quality of life score, lung function were not significantly improved （all P〉0.05）. Conclusion： Simvastatin can reduce systemic inflammation in COPD patients and relieve symptoms.