阿奇霉素联合辛伐他汀治疗慢性阻塞性肺疾病合并肺动脉高压的系统评价

发布时间：2019-05-05 16:31

【摘要】：目的:肺动脉高压是慢性阻塞性肺疾病常见并发症及主要死因之一,目前治疗效果欠佳。有研究认为阿奇霉素联合辛伐他汀可有效治疗慢性阻塞性肺疾病合并肺动脉高压,但相关循证医学证据不充分。本研究拟采用Meta分析方法分析阿奇霉素联合辛伐他汀治疗慢性阻塞性肺疾病合并肺动脉高压的疗效,为临床治疗提供循证依据。方法:通过计算机检索PubMed、EMbase、The Cochrane Library(2017年01期)、维普(VIP)、中国生物医学文献数据库(CBM)、中国期刊数据库(CNKI)和万方数据库(Wan Fang)等各大中英文数据库,检索时间从建库开始截止到2017年01月,收集关于阿奇霉素联合辛伐他汀治疗慢性阻塞性肺疾病合并肺动脉高压的随机对照试验(RCT)。对符合所有纳入标准的研究文献采用Cochrane网推荐的评价工具进行仔细的质量评价,最后再使用RevMan 5.2统计软件进行相关的数据分析。结果:共纳入9项随机对照试验,792名慢性阻塞性肺疾病合并肺动脉高压的患者。Meta分析结果显示:与对照组比较,观察组的血氧分压[MD=2.01,95%CI(1.8,2.23),P0.00001]、血氧饱和度[MD=3.82,95%CI(3.17,4.48),P0.00001]、6分钟步行距离[MD=75.03,95%CI(70.48,79.58),P0.00001]、FEV1[MD=0.25,95%CI(0.23,0.27),P0.00001]和FVC[MD=0.38,95%CI(0.35,0.41),P0.00001]均显著升高。肺动脉收缩压[MD=-1.49,95%CI(-1.70,-1.27),P0.00001]、肺动脉舒张压[MD=-1.40,95%CI(-1.52,-1.29),P0.00001]均下降。结论:阿奇霉素联合辛伐他汀能很好改善慢性阻塞性肺疾病合并肺动脉高压患者的血氧分压、血氧饱和度、6分钟步行距离、肺功能,降低肺动脉压。
[Abstract]:Objective: pulmonary hypertension is a common complication and one of the main causes of death in chronic obstructive pulmonary disease (COPD). It is believed that azithromycin combined with simvastatin can effectively treat chronic obstructive pulmonary disease complicated with pulmonary hypertension, but evidence-based medicine is insufficient. In this study, Meta analysis was used to analyze the efficacy of azithromycin combined with simvastatin in the treatment of chronic obstructive pulmonary disease complicated with pulmonary hypertension, and to provide evidence-based evidence for clinical treatment. Methods: a computer-based search of PubMed,EMbase,The Cochrane Library (01 / 2017), Wip (VIP), Chinese Biomedical Literature Database (CBM), Chinese Journal Database (CNKI) and Wanfang Database (Wan Fang) were conducted in various Chinese and English databases. A randomized controlled trial of azithromycin combined with simvastatin in the treatment of chronic obstructive pulmonary disease complicated with pulmonary hypertension (RCT).) was collected from January 2017 until January 2017. The evaluation tools recommended by Cochrane net are used to evaluate the quality of all the research documents which meet the inclusion criteria. Finally, the related data analysis is carried out by using RevMan 5.2 statistical software. Results: a total of 9 randomized controlled trials were conducted in 792 patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension. The results of meta-analysis showed that the partial pressure of blood oxygen [MD=2.01,95%CI (1.8, 2.23) in the observation group was significantly higher than that in the control group [(1.8, 2.23)]. P0.00001], oxygen saturation [MD=3.82,95%CI (3.17,4.48), P0.00001], 6-minute walking distance [MD=75.03,95%CI (70.48, 79.58), P0.00001], FEV1 [MD=0.25,95%CI (0.23,0.27), P 0.00001] and FVC [MD=0.38,95%CI (0.35, 0.41), P 0.00001] were significantly increased. Pulmonary systolic blood pressure [MD=-1.49,95%CI (- 1.70,1.27), P0.00001] and pulmonary artery diastolic pressure [MD=-1.40,95%CI (- 1.52, 1.29), P0.00001] were all decreased. Conclusion: azithromycin combined with simvastatin can improve the blood oxygen partial pressure, blood oxygen saturation, 6 minute walking distance, pulmonary function and decrease pulmonary artery pressure in patients with chronic obstructive pulmonary disease complicated with pulmonary hypertension.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9;R544.1

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