Characterization of arrhythmia in pulmonary hypertension in patients with bronchial obstructive diseases

To study the pattern and incidence of arrhythmias in relation to the mean pulmonary trunk pressure (MPTP), 24-hour SCG monitoring and Doppler pulse EchoCG were performed in 32 patients with chronic obstructive lung disease and in 13 patients with bronchial asthma. The summarized results of 24-hour ECG suggest that the number and grades of arrhythmias increase when MPTP becomes more than 13 mm Hg. There is a highly significant mean force correlation between MPTP and complicated cardiac arrhythmias (paroxysmal supraventricular tachycardia, coupled ventricular extrasystoles, and unsteady ventricular tachycardia). A more than 13 mm increase in MPTP may be a predictor for the assessment of a risk of the existence of complicated cardiac arrhythmias on an exacerbation of bronchial obstructive lung diseases.     

基质金属蛋白酶在慢性阻塞性肺疾病大鼠中的表达及意义

目的 检测慢性阻塞性肺疾病(COPD)大鼠基质金属蛋白酶(MMP)的表达并探讨其临床意义.方法Wistar雄性大鼠36只,随机分为正常对照组、模型组和用药组,每组12只.模型组与用药组均给予被动吸烟染毒75 d,制备COPD模型;用药组在每次吸烟染毒前通过胃管灌食维A酸15 ms/ks,75 d后处死大鼠.正常对照组气管内滴入等量生理盐水,25 d后处死.观察各组大鼠肺组织的病理改变,免疫组化及酶联免疫吸附法检测肺组织MMP表达情况.结果模型组、用药组和正常对照组MMP-2和MMP-9的活性和表达两两比较差异有统计学意义(均P<0.01).结论MMP在COPD病变肺组织中表达水平增加,参与COPD的发生和发展.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

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37例,给予常规治疗20例,辛伐他汀40mg/d治疗17例,比较治疗前和治疗4周患者鼻灌洗液和痰中细胞数、中性粒细胞百分比(N%)和IL-8、IL-6浓度,检测血清CRP、IL-8、IL-6及TC和LDL-C浓度,并观察肺功能、生活质量评分(SNOT-20)、呼吸问卷(SGRQ)评分的变化.结果 4周后辛伐他汀组鼻灌洗液和痰中细胞总数、N%、IL-8、IL-6[鼻灌洗液:(0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5)ng/L,(3.8±1.6)ng/L;痰:(0.8±0.3)×109/L,(56.6±9.6)%,(2565.5±831.9)ng/L,(109.8±42.3)ng/L]较治疗前[鼻灌洗液:(0.8±0.3)×107/L、(43.2±10.8)%、(107.6±86.3)ng/L、(4.1±1.9)ng/L;痰:(0.8±0.3)×109/L、(58.1±9.3)%、(2659.4±885.2)ng/L、(111.8±46.6)ng/L]轻度降低,但差异无统计学意义(P均>0.05);血清CRP、IL-6和TC、LDL-C水平显著减低[治疗前分别为(4.3±3.7)mg/L、(4.8±2.0)ng/L、(4.2±1.0)mmol/L、(2.4±0.5)mmoL/L;治疗后分别为(2.6±1.8)mg/L、(4.7±1.9)ng/L、(3.7±0.8)mmol/L、(2.2±0.5)mmol/L,P均<0.05],IL-8浓度轻度降低[(6.2±1.8)ng/L与(6.4±1.9)ng/L],但差异无统计学意义(P>0.05);SGRQ各项分值中症状评分明显减低[(39.6±10.8)分与(32.3±11.6)分,P<0.05],其他观察项目(SNOT-20量表评分、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.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

辛伐他汀对慢性阻塞性肺疾病患者全身性炎症反应的影响

Objective To investigate the influence of simvastatin on inflammatory indices in nasal lavage,sputum and blood and clinical index in patients with chronic obstructive pulmonary diseases (COPD). Methods Thirty-seven stable COPD patients were randomly divided into simvastatin-treatment group (n=17),orally given simvastatin tablets for 4 weeks in addition to basic therapy,40 mg,qd) and control group (n=20),given usual med-ication). Total cell counts,percentage of leukocytes (N%) and levels of interleukin IL-8,IL-6 in nasal lavage and sputum at pre-post-treatment were compared;Serum C-reactive protein (CRP),total cholesterol (TC),low-density lipoprotein-cholesterol (LDL-C) as well as IL-8,IL-6 concentrations were measured,the variation of lung function,Sino-Nasal Outcome Test 20(SNOT-20) and St George's Respiratory Questionnaire(SGRQ) score were analyzed. Results After the treatment,the nasal lavage and sputum total cell counts,N%,IL-8 and IL-6 levels[nasal lavage: (0.7±0.3)×107/L,(41.1±10.9)%,(105.8±74.5) ng/L,(3.8±1.6) ng/L;sputum: (0.8±0.3)×109/L,(56.6±9.6) %,(2565.5±831.9) ng/L,(109.8±42.3) ng/L] dropped slightly in the simvastatin group com-pared with that at pretreatment [nasal lavage: (0.8±0.3)×107/L,(43.2±10.8) %,(107.6±86.3) ng/L,(4.1±1.9)ng/L;sputum: (0.8±0.3)×109/L,(58.1±9.3)% ,(2659.4±885.2) ng/L,(111.8±46.6) ng/L] (P>0.05) ;There were significant decreases in serum CRP [(4.3±3.7) mg/L vs (2.6±1.8) mg/L],IL-6 [(4.8±2.0)ng/L vs(4.7±1.9)ng/L] ,TC[(4.2±1.0) mmol/L vs(3.7±0.8)mmol/L] ,LDL-C[(2.4±0.5) mmol/L vs (2.2±0.5)mmol/L] (P>0.05) ;IL-8 concentrations in serum were lower gently[(6.2±1.8) ng/L vs (6.4±1.9) ng/L] (P>0.05). Significant change of simvastatin treatment on SGRQ was only reflected in the symp-tom score [pre-post-treatment:39.6±10. 8 vs 32.3±11.6,P<0.05,respectively],while other observation items (SNOT-20,FEV1%,FEV1/FVC) changed not notably (P>0.05). No marked changes in inflammatory markers and quality of life scores,lung function were observed in control group (P>0.05). Conclusion Simvastatin may be as-sociated with the potential to alleviate systemic inflammation and relieve symptoms in COPD patients.     

Clinical characteristics and condition of the bronchial tree in patients with bronchial asthma and chronic obstructive pulmonary disease in combination with hyperoxaluria

AIM: To evaluate peculiarities of a clinical course and changes in bronchial mucosa in bronchial asthma (BA) patients with chronic obstructive pulmonary disease (COPD) in combination with hyperoxaluria (HOU); informative value of some laboratory and device findings including oxalates assay in bronchial lavage fluid for specification of the diagnosis, role of oxalates in development of obstructive syndrome and choice of optimal therapy. MATERIAL AND METHODS: Oxalates were examined in daily urine, bronchoalveolar lavage fluid and exhaled air condensate of 104 patients with BA and COPD, 77 of which had HOU and an atypical course of bronchial obstruction syndrome. RESULTS: Conception of airways inflammation in patients with oxalate metabolism disturbances is proposed. It is shown that insoluble oxalates participate in pathogenesis of bronchial obstruction. CONCLUSION: Oxalate metabolism disturbances are an important factor in pathogenesis of airways inflammation and development of bronchial obstruction in predisposed patients. Therefore, administration of insoluble oxalates lowering therapy may effectively prevent formation and progression of obstructive pulmonary diseases in this group of patients.     

慢性阻塞性肺疾病急性加重的临床意义

慢性阻塞性肺疾病（COPD）急性加重（AECOPD）特征是患者的呼吸困难、咳嗽和（或）咯痰出现了超常的变化，需要对治疗进行调整。COPD患者常经历急性加重，每一次发作将加重疾病并促进疾病的发展，AECOPD的程度和频率均可以加重基础疾病，COPD患者1年内平均出现1～3次急性加重，可导致患者病死率增高。因此，AECOPD是COPD的重要评价指标，对急性加重预防和医疗资源利用的评估是COPD治疗的重要目标。     

哮喘慢性阻塞性肺疾病重叠综合征的临床特点

人们逐渐认识到哮喘和慢性阻塞性肺疾病(COPD)是一种异质性疾病,就其临床表现,疾病进展和对治疗的反应而言,具有极大的个体差异性。哮喘慢性阻塞性肺疾病重叠综合征(ACOS)的引入可能会更好的体现其临床特点。目前进行的研究一般都是基于症状来诊断ACOS,不完全可逆气流受限,支气管扩张试验阳性,气道高反应,嗜酸粒细胞炎症,过敏性疾病的历史,和烟雾暴露是ACOS的重要组成部分。迄今为止进行的研究用不同的标准来定义ACOS,总的来说,ACOS综合征被定义为两种临床表型:哮喘-ACOS和COPD-ACOS。每个表型都有一个不同的潜在的病理生理、临床特点和预后。ACOS的治疗应根据表型定制。然而,ACOS仍处于初级阶段,并需做出很大的改进。     

3项指标联合检测在慢性阻塞性肺疾病中的临床意义

目的：探讨 D‐二聚体、心肌肌钙蛋白 I（cTnI）和血清 N 末端 B 型钠尿肽原（NT‐proBNP）在慢性阻塞性肺疾病（COPD）急性加重期及治疗缓解期的浓度变化及临床意义。方法检测40例 COPD 患者急性加重期及治疗缓解期 D‐二聚体、cTnI 和 NT‐proBNP 水平,同期选择体检健康者40例纳入对照组,检测3项指标水平并进行比较。结果 COPD 急性加重期 D‐二聚体、cTnI 、NT‐proBNP 水平分别为（1．83±1．14）μg／mL 、（1．16±0．60）ng／mL 和（819．62±172．37）pg／mL ,均明显高于缓解期患者的（0．53±0．24）μg／mL 、（0．55±0．12）ng ／mL 和（250．80±79．90）pg／mL ,差异均有统计学意义（P＜0．05）。 COPD 缓解期D‐二聚体、cTnI 和 NT‐proBNP 水平均高于对照组的（0．22±0．10）μg／mL 、（0．13±0．05）ng／mL 和（85．81±31．13）pg ／mL ,差异均有统计学意义（P＜0．05）。结论 D‐二聚体、cTnI 和 NT‐proBNP 水平在 COPD 患者中明显升高,其联合检测对于 COPD 的诊断、进展及治疗具有重要的临床指导意义。     

慢性阻塞性肺疾病并低钠血症38例临床分析

目的：探讨慢性阻塞性肺疾病合并低钠血症的病因、临床表现及防治措施。方法：对38例慢性阻塞性肺疾病合并低钠血症进行回顾性分析。结果：慢性阻塞性肺疾病急性发作期合并低钠血症时，肺、脑等重要器官系统的功能失常，使病情复杂、加重。结论：慢性阻塞性肺疾病合并低钠血症病因复杂，控制原发病，预防并及早治疗低钠血症有重要的临床意义。     

小剂量克拉霉素对慢性阻塞性肺疾病的临床应用研究

目的观察小剂量克拉霉素对稳定期重度慢性阻塞性肺疾病（COPD）患者的肺功能、生活质量、急性发作的影响。方法将60例稳定期重度COPD患者随机分成观察组和对照组。观察组给予克拉霉素片250mg一日一次口服．持续12周．对照组不用任何药物。观察两组患者治疗前后的第一秒用力呼气容积占预计值百分比（FEV1％）、圣乔治呼吸问卷（SGRQ）测定的生活质量,并记录两组12周内急性发作的人数。结果观察组治疗后FEV1％、SGRQ评分与对照组比较,差异均有统计学意义（t分别=3．11、2．17、2．26、4．97、3．23,P均〈0．05）;与治疗前比较,差异均有统计学意义（t分别=2．33、2．79、2．03、3．44、3．14,P均〈0．05）。仅2例有轻微胃肠道反应,继续用药后症状减轻,所有患者均完成12周的治疗。治疗后复查肝肾功能均在正常范围。12周内观察组急性发作4人,对照组急性发作11人。两组比较,差异有统计学意义（x^2=4．36．P〈0．05）。结论长期应用小剂量克拉霉素可以改善稳定期重度COPD的肺功能、生活质量、减少急性发作。