长期小剂量阿奇霉素治疗慢性阻塞性肺疾病的初步研究

目的研究长期小剂量阿奇霉素治疗对慢性阻塞性肺疾病(COPD)是否有疗效。方法选择稳定期COPD病人65例,随机分成两组,治疗组口服阿奇霉素0.25g,每日1次,连续用药6周。对照组不用任何药。两组病人在病情加重时,临时应用茁-内酰胺类抗生素。治疗前、治疗6周后检测肺功能1s用力呼气容积(FEV1)和血浆白细胞介素(IL)-6、IL-8及肿瘤坏死因子(TNF)-琢的浓度,并记录临床症状记分。结果60例完成了试验,治疗组30例临床症状改善治疗前(4.1±0.4)分,治疗后(3.8±0.5)分,P<0.01];FEV1也有改善治疗前(1.68±0.23)L,治疗后(1.72±0.21)L,P<0.05];血浆IL-8浓度治疗前(8.5±2.6)pg/ml,治疗后(8.5±2.6)pg/ml]、IL-6浓度治疗后(7.1±2.8)pg/ml,治疗后(7.0±2.8)pg/ml]及TNF-琢浓度治疗前(7.6±2.7)pg/ml,治疗后(7.5±2.7)pg/ml]均无明显改变(P>0.05)。对照组(30例)治疗前后各项指标差异无显著性(P>0.05),治疗期间未再见明显副作用。结论长期小剂量阿奇霉素治疗COPD患者可改善临床症状和其肺功能,且安全性好,不影响对血浆IL-8、IL-6及TNF-琢的浓度。

Preliminary study on long-term small-dosed azithromycin to treat chronic obstructive pulmonary disease

Objective Whether there is curative effect of azithromycin on chronic obstructive pulmonary disease (COPD) or not is under survey. Methods Sixty-five stable-staged COPD patients were chosen and divided randomly into two groups; the treated group received orally azithromycin 0.25 g once daily for 6 weeks, the control group did not receive any drugs. If the patients of both groups ran an exacerbation, temporary use of β-lactam antibiotics must be given to them. Before the azithromycin treatment and 6 weeks after the treatment both saw the detection of lung function, FEV1 (forced expiratory volume in one second), plasma levels of IL-8, IL-6 and TNF-α, as well as the scoring of clinical symptoms. Results There were 60 patients who fulfilled their tests; 30 patients of the treated group got improved clinical indices, ie, (4.1±0.4) score before treatment, (3.8±0.5) score after treatment (P<0.01); FEV1 also increased, ie, (1.68±0.23) L before treatment, (1.72±0.21) L after treatment (P<0.05); plasma levels of IL-8, (8.5±2.6) pg/ml before treatment, (8.5±2.6) pg/ml after treatment; IL-6, (7.1±2.8) pg/ml before treatment, (7.0±2.8) pg/ml after treatment; and TNF-α, (7.6±2.7) pg/ml before treatment, (7.5±2.7) pg/ml after treatment; no marked difference between before and after treatments (P>0.05). Thirty patients of the control group got no marked difference in their indices between before and after treatments (P>0.05). During the whole treatment, no obvious adverse reaction occurred. Conclusion Long-term small-dosed azhithromycin used for treating COPD is able to relieve the clinical symptom and improve the lung function, with a fairly good safety, not affecting the plasma levels of IL-8, IL-6 and TNF-α.