摘要
目的:研究不同用药疗程小剂量(0.25 g·d^(-1))阿奇霉素口服对稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者临床疗效和安全性的影响。方法:将165例稳定期COPD患者随机分为3组:用药3个月(A组)、用药6个月(B组)和用药12个月(C组),每组55例。比较3组治疗前后最大呼气量(PEF)、第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量百分率(FEV1/FVC%)、6 min步行距离(6 MWT)、圣乔治呼吸问卷评分(SGRQ)、呼吸困难评分(MRC)、急性加重次数及不良反应发生率。结果:13例患者脱落,共有152例患者(A组、B组和C组分别有52例、51例和49例)完成本研究。3组患者PEF、FEV1、FEV1/FVC%、6 MWT、SGRQ评分和MRC评分、急性加重次数均较治疗前显著改善(P<0.05)。组间比较,B组和C组患者的PEF、FEV1、FEV1/FVC%、6 MWT、SGRQ评分、MRC评分和急性加重次数与A组比较,差异分别为(0.62±0.18)L和(0.71±0.13)L、(0.39±0.09)L和(0.45±0.08)L、(5.92±1.18)%和(7.98±1.53)%、(83.69±11.27)m和(87.93±14.54)m、(15.57±3.37)分和(16.64±4.12)分、(-1.17±0.23)分和(-1.32±0.28)分、(0.67±0.09)次/年和(0.71±0.12)次/年,差异均有统计学意义(P<0.05);B组与C组比较,PEF、FEV1、FEV1/FVC%、6 MWT、SGRQ评分、MRC评分和急性加重次数的差异分别为(0.09±0.03)L、(0.06±0.04)L、(2.06±0.87)%、(4.24±1.75)m、(1.07±0.68)分、(-0.15±0.11)分和(-0.04±0.01)次/年,差异无统计学意义(P>0.05)。A组、B组和C组患者不良反应发生率分别为7.69%、9.80%和18.37%,差异均无统计学意义(P>0.05)。结论:阿奇霉素3种用药疗程均能显著改善稳定期COPD患者肺功能和生活质量,但用药6个月是最佳疗程。
OBJECTIVE To explore the efficacy and safety of oral azithromycin(0.25 g·d^(-1)) with different courses for patients with stable chronic obstructive pulmonary disease(COPD).METHODS A total of 165 patients with stable COPD were divided into 3 groups(n=55 each). They were treated for 3 months(Group A), 6 months(Group B) and 12 months(Group C). Peak expiratory flow(PEF), forced expiratory volume in the first second(FEV1), forced expiratory volume in the first second, percentage of forced vital capacity(FEV1/FVC%), six-minute walk test(6 MWT), St George’s aspiration questionnaire score(SGRQ), medical research council(MRC), frequency of acute exacerbation and the incidence of adverse reaction were compared among three groups before and after treatment.RESULTS Thirteen cases dropped out. A total of 152 cases(52 in group A, 67 in group B and 49 in group C) completed the study. The results showed that PEF, FEV1, FEV1/FVC%, 6 MWD, SGRQ/MRC score and frequency of acute exacerbations improved markedly in all three groups(P<0.05). Intergroup comparisons: Group B/C was compared with group A in PEF, FEV1, FEV1/FVC%, 6 MWD, SGRQ score, MRC score and frequency of acute exacerbations, the difference were(0.62±0.18)L vs.(0.71±0.13)L,(0.39±0.09)L vs.(0.45±0.08)L,(5.92±1.18)% vs.(7.98±1.53)%,(83.69±11.27) m vs.(87.93±14.54) m,(15.57±3.37) points vs.(16.64±4.12) points,(-1.17±0.23) points vs.(-1.32±0.28) points and(0.67±0.09) times/year vs.(0.71±0.12) times/year. All differences were statistically significant(all P<0.05). Group B was compared with group C in PEF, FEV1, FEV1/FVC%, 6 MWD, SGRQ/MRC score and frequency of acute exacerbations, the difference were(0.09±0.03)L,(0.06±0.04)L,(2.06±0.87)%,(4.24±1.75)m,(1.07±0.68) points,(-0.15±0.11) points and(-0.04±0.01) times/year, the differences were not statistically significant(P<0.05). The incidence of adverse reactions in Groups A, B and C were 7.69%, 9.80% and 18.37% respectively. And there were no significant difference(P>0.05).CONCLUSION Three treatment courses of azithromycin can significantly improve pulmonary functions and quality-of-life in patients with stable COPD. However, 6 months is the best course.
作者
张媛媛
王宁
谭瑞娟
陈赫军
王立丹
张晓燕
王金荣
ZHANG Yuan-yuan;WANG Ning;TAN Rui-juan;CHEN He-jun;WANG Li-dan;ZHANG Xiaoyan;WANG Jin-rong(Department of Pharmacy,Hengshui Municipal People's Hospital,Hebei Hengshui 053000,China;Department of Respiratory Critical Medicine,Hengshui Municipal People's Hospital,Hebei Hengshui 053000,China;Department of Critical Care Medicine,Hengshui Municipal People's Hospital,Hebei Hengshui 053000,China)
出处
《中国医院药学杂志》
CAS
北大核心
2021年第3期282-286,共5页
Chinese Journal of Hospital Pharmacy
