文章摘要
窦志芳,陈乾华,付 伟,郑 野,王 敏.胸腺五肽联合辛伐他汀治疗COPD合并肺动脉高压的疗效及对患者血清PAF-AH、esRAGE、CA125水平的影响[J].,2019,19(18):3536-3540
胸腺五肽联合辛伐他汀治疗COPD合并肺动脉高压的疗效及对患者血清PAF-AH、esRAGE、CA125水平的影响
Curative Efficacy of Thymic Five Peptide Combined with Simvastatin in the Treatment of COPD Combined with Pulmonary Hypertension and Its Effects on the Serum PAF-AH, esRAGE and CA125 Levels
投稿时间:2019-02-24  修订日期:2019-03-21
DOI:10.13241/j.cnki.pmb.2019.18.030
中文关键词: 慢性阻塞性肺疾病  肺动脉高压  胸腺五肽  辛伐他汀  血清因子
英文关键词: Chronic obstructive pulmonary disease  Pulmonary hypertension  Thymic five peptide  simvastatin  Serum factor
基金项目:北京市科技计划项目(Z14110700251409)
作者单位E-mail
窦志芳 中国医科大学航空总医院 呼吸科 北京 100012 yinghuajin06@aliyun.com 
陈乾华 中国医科大学航空总医院 呼吸科 北京 100012  
付 伟 中国医科大学航空总医院 呼吸科 北京 100012  
郑 野 中国医科大学航空总医院 呼吸科 北京 100012  
王 敏 甘肃省中医药大学附属医院 呼吸科 甘肃 兰州 730000  
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中文摘要:
      摘要 目的:探讨胸腺五肽联合辛伐他汀治疗慢性阻塞性肺疾病(COPD)合并肺动脉高压的疗效及对患者血清血小板活化因子乙酰水解酶(PAF-AH)、内源性分泌型晚期糖基化终末产物受体(esRAGE)、糖类抗原125(CA125)水平的影响。方法:选择2016年1月至2017年12月我院接诊的65例COPD合并肺动脉高压患者,通过随机数表法分为观察组35例和对照组30例。对照组在常规治疗基础上给予辛伐他汀治疗,观察组在对照组基础上给予胸腺五肽治疗,两组均连续治疗4周。治疗后,比较两组血清PAF-AH、esRAGE、CA125水平、免疫功能、肺功能、血气分析指标的变化及不良反应的发生情况。结果:治疗后,观察组血清PAF-AH、esRAGE水平明显高于对照组,而血清CA125水平明显低于对照组[(187.20±15.10)ng/mL vs. (135.13±11.42)ng/mL,(0.32±0.08)ng/L vs. (0.26±0.05)ng/L,(21.06±3.27)U/mL vs. (30.49±4.23)U/mL](P<0.05);观察组CD3+、CD4+、CD4+/CD8+明显高于对照组[(69.56±7.89)% vs. (57.56±6.05)%,(43.30±5.11)% vs. (37.86±4.53)%,(2.14±0.30) vs. (1.82±0.26)](P<0.05);观察组血清第一秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)明显高于对照组,肺动脉收缩压(PASP)明显比对照组低[(2.17±0.34)L vs(1.84±0.29)L,(67.34±8.28)% vs. (60.37±6.05)%,(36.23±3.15)mmHg vs. (42.85±3.88)mmHg](P<0.05);观察组动脉血压分压(PaO2)明显高于对照组,二氧化碳分压(PaCO2)明显低于对照组[(89.45±7.40)mmHg vs. (80.23±6.82)mmHg,(33.83±3.11)mmHg vs. (40.02±3.86)mmHg](P<0.05)。两组不良反应的总发生率比较差异无统计学意义(P>0.05)。结论:胸腺五肽联合辛伐他汀治疗COPD合并肺动脉高压患者效果显著优于单用辛伐他汀治疗,可更有效改善患者肺功能和肺动脉高压状态,其内在机制可能和调节血清PAF-AH、esRAGE、CA125水平及缓解气道炎症反应相关。
英文摘要:
      ABSTRACT Objective: To study the curative efficacy of thymic five peptide combined with simvastatin in the treatment of chronic obstructive pulmonary disease(COPD) combined with pulmonary hypertension and its effects on the serum platelet-activating factor acetylhydrolase(PAF-AH), endogenous secretory receptor for advanced glycation end products(esRAGE) and carbohydrate antigen(CA125) levels. Methods: 65 patients of COPD combined with pulmonary hypertension who received therapy from January 2016 to December 2017 in our hospital, they were divided into observation group (35 cases) and control group (30 cases) by random number table method, the control group was treated with simvastatin on the basis of routine treatment, while the observation group was treated with thymopentin, they were treated for 4 weeks. The changes of serum PAF-AH, esRAGE, CA125, immune function, lung function, blood gas analysis index and adverse reactions were compared between the two groups. Results: After treatment, the serum PAF-AH and esRAGE levels in the observation group were significantly higher than those in the control group, and serum CA125 levels was significantly lower than those in the control group[(187.20±15.10)ng/mL vs. (135.13±11.42)ng/mL, (0.32±0.08)ng/L vs. (0.26±0.05)ng/L, (21.06±3.27)U/mL vs. (30.49±4.23)U/mL](P<0.05); the CD3+, CD4+ and CD4+/CD8+ levels in the observation group were significantly higher than those in the control group[(69.56±7.89)% vs. (57.56±6.05)%,(43.30±5.11)% vs. (37.86±4.53)%, (2.14±0.30) vs. (1.82±0.26)](P<0.05); the first second forced expiratory volume (FEV1) and FEV1/forced vital capacity (FVC) in the observation group were significantly higher than those in the control group, and the pulmonary systolic pressure (PASP) was significantly lower than those in the control group[(2.17±0.34)L vs. (1.84±0.29)L,(67.34±8.28)% vs. (60.37±6.05)%,(36.23±3.15)mmHg vs. (42.85±3.88)mmHg](P<0.05); the partial pressure of arterial blood pressure (PaO2) in the observation group was significantly higher than those in the control group, and the partial pressure of carbon dioxide (PaCO2) was significantly lower than those in the control group[(89.45±7.40)mmHg vs. (80.23±6.82)mmHg, (33.83±3.11)mmHg vs. (40.02±3.86)mmHg](P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Thymic five peptide combined with simvastatin in the treatment of COPD patients with pulmonary hypertension is significantly better than simvastatin alone., it's helpful to improve pulmonary function and pulmonary hypertension. Its internal mechanism may be related to the regulation of serum PAF-AH, esRAGE, CA125 lelves and alleviating airway inflammation.
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