红霉素治疗COPD.doc

Long-Term Macrolide Use May Help Reduce COPD Exacerbations长期使用大环内酯类抗生素可能有助于减少慢性阻塞性肺疾病加重November 21, 2008 — Long-term use of erythromycin was effective in reducing exacerbations of chronic obstructive pulmonary disease (COPD), according to the results of a randomized, double-blind, placebo-controlled study reported in the December 1 issue of the American Journal of Respiratory and Critical Care Medicine. 2008年11月21日-1 2月1日的美国呼吸和危重病医学杂志报告的一项随机双盲安慰剂对照研究的结果显示，长期使用红霉素可有效地减少慢性阻塞性肺疾病（COPD）加重 。Frequent [COPD] exacerbations are a major cause of hospital admission and mortality and are associated with increased airway inflammation, write Terence A. R. Seemungal, from University of the West Indies in Trinidad and Tobago, and colleagues. Macrolides have airway anti-inflammatory actions and may reduce the incidence of COPD exacerbations. “频繁[慢性阻塞性肺疾病]加重是病人入院和死亡的一个重要原因，并与气道炎症增加有关， ” Trinidad 和Tobago西印度群岛大学的Terence A. R. Seemungal及其同事报告， “大环内酯类抗生素有气道抗炎作用，并可能减少慢性阻塞性肺疾病加重的发生。 ”The goal of this study was to examine whether chronic macrolide therapy reduces the frequency of COPD exacerbations. Outpatients with COPD were randomly assigned to receive either erythromycin 250 mg or placebo twice daily for a 12-month period. The main study endpoint was the number of moderate and/or severe exacerbations, defined as those exacerbations that were treated with systemic steroids or antibiotics or that led to hospitalizations. 此项研究旨在弄清长期使用大环内酯类抗生素是否能降低慢性阻塞性肺疾病加重的频率。将门诊慢性阻塞性肺疾病患者随机分配服用红霉素250毫克或安慰剂，一日两次，疗程一年。主要研究终点是中重度加重的次数，将其定义为：需接受系统性类固醇或抗生素治疗或导致入院的COPD加重。Of 109 randomized outpatients, 69 (63%) were men, and 52 (48%) were current smokers. Mean age was 67.2 ± 8.6 years, mean forced expiratory volume in 1 second (FEV1) was 1.32 ± 0.53, and mean FEV1% predicted was 50% ± 18%. In the year before recruitment, 38 patients (35%) had at least 3 exacerbations, with no differences between treatment groups. 109例随机门诊病人， 69 例（ 63 ％ ）男性， 52 （ 48 ％ ）例为现时吸烟者。平均年龄为67.2 ± 8.6岁，平均第1秒用力呼气量（FEV1）为1.32 ± 0.5