阿奇霉素预防慢性阻塞性肺疾病急性加重的效果及药理分析

目的观察阿奇霉素预防慢性阻塞性肺疾病(COPD)急性加重的临床疗效及药理作用。方法将120例稳定期COPD患者随机分成治疗组和观察组,实验组60例患者在常规治疗基础上口服阿奇霉素分散片250 mg/d,对照组60例仅进行常规治疗。对两组患者治疗情况跟踪观察,比较两组患者肺功能、血C-反应蛋白、白细胞介素8(IL-8)、鼻咽部定植菌及首次出现急性加重时间。结果治疗前,两组患者肺功能、血C-反应蛋白、IL-8均差异无统计学意义;治疗后两组均有患者存在鼻咽部定植菌,其中治疗组4例,对照组7例,其差异有统计学意义(P<0.05);两组患者有少数产生轻微药物不良反应,但无需特殊治疗。结论每日口服低剂量阿奇霉素可以有效预防COPD急性加重,该治疗方法简单安全有效,无明显不良反应。

Analysis on Effect and Pharmacology of Azithromycin Preventing Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To observe the clinical efficacy and pharmacological action of azithromycin preventing acute exacerbation of chronic obstructive pulmonary disease. Methods 120 cases with stable-phase COPD were randomly divided into two groups, the treatment group and the observation group. The experiment group for 60 cases were treated with azithromycin dispersible tablets, 250 mg/d, based on the conventional treatment, and the control group for 60 cases only received conventional treatment. The treatment conditions of two groups were observed. And the lung function, C-reactive protein, IL-8, bacteria colonization in nose and pharynx and the first time of acute exacerbation of two groups were compared. Results Before treatment, there was no statistical significance for the difference of lung function, C-reactive protein, IL-8 and the first time of acute exacerbation between two groups. After treatment, there was evident difference for bacteria colonization in nose and pharynx between two groups, the control group had 7 cases and the observation group had 4 cases, which has statistical significance（P〈0.05）. There were few patients with adverse reactions on medicine without the need of treatment for two groups. Conclusion Taking low dose of azithromycin can effectively prevent acute exacerbation of COPD. The treatment method not only is safe and effective, but also has no evident adverse reactions.