阿托伐他汀治疗稳定期慢性阻塞性肺疾病的临床研究

目的观察阿托伐他汀对各级稳定期慢性阻塞性肺疾病（COPD）患者的治疗效果，探讨他汀类药物治疗COPD的时机。方法选择2012年2月至2013年5月本院门诊或住院COPD治疗后进人稳定期的患者为研究对象，Ⅰ级-Ⅳ级稳定期COPD患者各40例，每级患者按随机数字表法分为常规治疗组（对照组）和阿托伐他汀组（治疗组），每组20例。常规治疗组中Ⅰ级患者按需吸入沙丁胺醇气雾剂，Ⅱ级患者在Ⅰ级患者治疗基础上规律使用一种或多种长效支气管扩张剂，Ⅲ级及Ⅳ级患者如反复出现急性加重，则在Ⅱ级患者治疗基础上加用沙美特罗／氟替卡松，Ⅳ级患者伴慢性呼吸衰竭者予家庭氧疗。阿托伐他汀组在常规治疗的基础上加用阿托伐他汀（20mg／粒，辉瑞药制有限公司）1粒，每晚睡前服用。结果Ⅰ-Ⅳ级治疗组患者肺功能指标（FEV1）下降幅度分别是（23±10）ml、（12±7）ml、（9±5）ml、（4±3）ml，对照组患者肺功能指标（FEV1）下降幅度分别是（60±21）ml、（50±15）ml、（45±12）ml、（20±8）ml，同级治疗组与对照组FEV1下降值比较差异有统计学意义（P〈0．05）。各级对照组6min步行距离（6MWD）减少，COPD评估测试（ACT）评分增加，急性加重次数增加；治疗组6MWD、ACT评分、急性加重次数较治疗前均有改善。同级治疗组与对照组以上三项指标比较差异均有统计学意义（P〈0．05）。结论阿托伐他汀可减缓各级COPD患者肺功能下降速度、改善生命质量、减少急性加重次数，早期用药有利于改善病程。

Atovastatin for chronic obstructive pulmonary disease in stable stage

Objective To observe the treatment efficacy of atorvastatin for patients with different severities of chronic obstructive pulmonary disease （COPD） in stable stage. To investigate the timing of statin therapy for COPD. Methods Out-patients and inpatients with COPD got into stable stage being treated at our hospital from February to May, 2013 were chosen as study objects. There were 40 cases in each severity degree of Ⅰ - Ⅳ. Patients of each degree were randomly divided into conventional treatment groups （control groups） and atorvastatin groups （treatment groups）, with 20 for each group. The control group of degree Ⅰ inhaled albuterol aerosol when needed; in addition, the one of degree Ⅱ regularly took one or more long-acting bronehodilators; the ones of degree Ⅲ and Ⅳ took salmeterol / fluticasone basing on the treatment of the one of degree Ⅱ if repeatedly occurring acute exacerbations; patients of degree IV were treated with home oxygen therapy if they had chronic respiratory failure. In addition, the atorvastatin groups took 20 mg atorvastatin （20mg / tablet, by Pfizer Ltd） every night at bedtime. Results The lung function （FEV1） decreased （23 ± 10） ml, （12 ± 7） ml, （9 ± 5） ml, and （4 ± 3） ml in the treatment groups and （60 ± 21） ml, （50 ± 15） ml, （45 ± 12） ml, and （20 ± 8） ml in the control groups of degree Ⅰ - Ⅳ, respectively, with statistical differences between the control groups and treatment groups of the same degree（P 〈 0.05）. 6 rain walk test （6MWT） decreased, COPD Assessment Test （ACT） score increased, and the occurring frequency of acute exacerbations increased in all the control groups; 6MWT, COPD Assessment Test （ACT） score, and the occurring frequency of acute exacerbations were better compared with those before the treatment in all the treatment groups; there were statistical differences in the three indicators between the control groups and treatment groups of the same degree （P 〈 0,05）. Conclusi