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引用本文:甄玲,李璐,刘吉羊,胡晓飞,唐晓霞.小剂量阿奇霉素联用辛伐他汀治疗慢性阻塞性肺病合并肺动脉高压的系统评价[J].中国现代应用药学,2018,35(1):111-116.
ZHEN Ling,LI Lu,LIU Jiyang,HU Xiaofei,TANG Xiaoxia.Meta analysis of low-doses of Azithromycin combined with Simvastatin in the treatment of Chronic Obstructive Pulmonary Disease Combined with Pulmonary Hypertension[J].Chin J Mod Appl Pharm(中国现代应用药学),2018,35(1):111-116.
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小剂量阿奇霉素联用辛伐他汀治疗慢性阻塞性肺病合并肺动脉高压的系统评价
甄玲1, 李璐1, 刘吉羊1, 胡晓飞2, 唐晓霞3
1.武汉科技大学附属孝感医院, 档案管理科, 湖北 孝感 432000;2.武汉科技大学附属孝感医院, 呼吸内科, 湖北 孝感 432000;3.武汉科技大学附属孝感医院, 药学部, 湖北 孝感 432000
摘要:
目的 系统评价小剂量阿奇霉素联用辛伐他汀治疗慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)合并肺动脉高压(pulmonary hypertension,PH)的临床疗效和安全性。方法 计算机检索PubMed、Medline、CNKI、VIP、万方等数据库,收集小剂量阿奇霉素联用辛伐他汀治疗COPD合并PH的临床随机对照研究,检索年限为2000年1月—2016年10月。由2名研究者独立提取数据、评价质量,并交叉核对。采用RevMan 5.2软件进行meta分析。结果 共纳入11项研究,943例患者。Meta分析结果显示,小剂量阿奇霉素联用辛伐他汀能显著提高COPD合并HP患者一秒用力呼吸容积[MD=0.31,95% CI(0.24,0.38),P>0.001]、血氧饱和度[MD=3.89,95% CI(3.29,4.50),P>0.001]、6s步行距离[MD=77.01,95% CI(72.88,81.14),P>0.001],显著降低肺动脉压[MD=-1.82,95% CI(-2.27,-1.36),P>0.001]和C反应蛋白[MD=-8.91,95% CI(-10.42,-7.39),P>0.001]。2组均未发生严重不良反应。倒漏斗图提示发表偏倚性较小。结论 小剂量阿奇霉素联用辛伐他汀能显著改善COPD合并PH患者肺功能、血氧饱和度,提高活动耐受力,同时显著降低肺动脉压和C反应蛋白,且安全可靠。
关键词:  阿奇霉素  辛伐他汀  慢性阻塞性肺疾病  肺动脉高压  临床疗效  meta分析
DOI:10.13748/j.cnki.issn1007-7693.2018.01.025
分类号:R969.3
基金项目:
Meta analysis of low-doses of Azithromycin combined with Simvastatin in the treatment of Chronic Obstructive Pulmonary Disease Combined with Pulmonary Hypertension
ZHEN Ling1, LI Lu1, LIU Jiyang1, HU Xiaofei2, TANG Xiaoxia3
1.Xiaogan Hospital Affiliated of Wuhan University of Science and Technology, Department of Archives management section, Xiaogan 432000, China;2.Xiaogan Hospital Affiliated of Wuhan University of Science and Technology, Department of Respiratory medicine, Xiaogan 432000, China;3.Xiaogan Hospital Affiliated of Wuhan University of Science and Technology, Department of medicine, Xiaogan 432000, China
Abstract:
OBJECTIVE To systematically review low-dose of azithromycin combined with simvastatin in treatment of chronic obstructive pulmonary disease(COPD) combined with pulmonary hypertension(PH). METHODS Databases including PubMed, Medline, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about low-dose of azithromycin combined with simvastatin in the treatment of COPD combined with PH from Jan. 2000 to Oct. 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.2 software. RESULTS Total of 11 RCTs, 943 patients were included. Meta-analysis showed that, low-dose of azithromycin combined with simvastatin could significantly improve the COPD combined with PH patients in FEV1[MD=0.25, 95%CI(0.18, 0.32), P>0.001], SaO2%[MD=3.89, 95%CI(3.29, 4.50), P>0.001], 6MWD[MD=76.25, 95%CI(71.95, 80.55, P>0.01], meanwhile significantly reduce in pulmonary hypertension[MD=-1.54, 95%CI(-1.83, -1.24), P>0.001] and CRP[MD=-8.86, 95%CI(-10.49, -7.23), P>0.001]. There were no serious adverse reactions in both groups. The inverted funnel plot suggested that the inclusion of the research publication bias was small. CONCLUSION Low-dose of azithromycin combined with simvastatin can improve lung function, dyspnea, the activity tolerancen and reduce pulmonary hypertension in patients with COPD combined with PH.
Key words:  azithromycin  simvastatin  chronic obstructive pulmonary disease  pulmonary hypertension  clinical efficacy  meta analysis
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