克拉霉素联合噻托溴胺治疗慢性阻塞性肺疾病(COPD)疗效

摘要

In order to conduct an observation on efficacy and changes in lung function of clarithromycin with tiotropium for curing COPD, 61 patients were infected with Chlamydia pneumoniae(Cpn) in the 101 eligible patients with COPD. Total 101 COPD patients were randomized into two groups: Tio group (tiotropium, Tio) and CT group (clarithromycin + tiotropium, CT). Antibody against C. pneumoniae were measured using MIF technique and rapid quantitation of C-reactive protein (CRP) was measured by DIGFA method. After treatment, the patient's clinical symptoms of two groups were improved markedly (P＜0.05 for Tio group; P＜0. 001 for CT group),and FEV1/FVC (％) increased significantly (P＜0.05 in Tio group, P＜0.01 in CT group). The CRP levels decreased significantly in both groups(P＜0.05), while the CT group was more remarkable than the Tio group (P=0. 0000 and P=0. 0134, respectively). The positive rates of Cpn-IgM were down significantly only in CT group (P= 0. 001 ). The result would be better in combined therapy of clarithromycin with tiotropium for curing COPD, so CT group regime is deserved to be expanded.%目的 观察克拉霉素联合噻托溴胺治疗COPD患者的临床疗效和肺功能变化.方法 符合入选条件的COPD101例患者中.61例病人感染过肺炎衣原体(Cpn).所有患者随机分成Tio组(用噻托溴胺治疗)和CT组(用克拉霉素+噻托溴胺治疗).用微量免疫荧光技术(MIF)检测抗Cpn抗体,胶体金法(DIGFA)快速定量测定C-反应蛋白(CRP).结果 治疗后两组病人的临床症状均有显著改善:Tio组P<0.05,CT组P<0.001;FEV1/FVC(%)CT组明显增强:Tio组P<0.05;CT组P<0.01;两组的CRP含量均下降,但CT组比Tio组更显著(分别为P=0.0000和P=0.0134);但CT组Cpn-IgM的阳性率显著下降(P=0.001).结论 克拉霉素联合噻托溴胺治疗COPD,二药合用可加强两种药物的协同疗效作用,使疗效更佳,因此CT方案值得临床推荐.