【摘要】：目的:肺動(dòng)脈高壓是慢性阻塞性肺疾病常見并發(fā)癥及主要死因之一,目前治療效果欠佳。有研究認(rèn)為阿奇霉素聯(lián)合辛伐他汀可有效治療慢性阻塞性肺疾病合并肺動(dòng)脈高壓,但相關(guān)循證醫(yī)學(xué)證據(jù)不充分。本研究擬采用Meta分析方法分析阿奇霉素聯(lián)合辛伐他汀治療慢性阻塞性肺疾病合并肺動(dòng)脈高壓的療效,為臨床治療提供循證依據(jù)。方法:通過計(jì)算機(jī)檢索PubMed、EMbase、The Cochrane Library(2017年01期)、維普(VIP)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、中國期刊數(shù)據(jù)庫(CNKI)和萬方數(shù)據(jù)庫(Wan Fang)等各大中英文數(shù)據(jù)庫,檢索時(shí)間從建庫開始截止到2017年01月,收集關(guān)于阿奇霉素聯(lián)合辛伐他汀治療慢性阻塞性肺疾病合并肺動(dòng)脈高壓的隨機(jī)對(duì)照試驗(yàn)(RCT)。對(duì)符合所有納入標(biāo)準(zhǔn)的研究文獻(xiàn)采用Cochrane網(wǎng)推薦的評(píng)價(jià)工具進(jìn)行仔細(xì)的質(zhì)量評(píng)價(jià),最后再使用RevMan 5.2統(tǒng)計(jì)軟件進(jìn)行相關(guān)的數(shù)據(jù)分析。結(jié)果:共納入9項(xiàng)隨機(jī)對(duì)照試驗(yàn),792名慢性阻塞性肺疾病合并肺動(dòng)脈高壓的患者。Meta分析結(jié)果顯示:與對(duì)照組比較,觀察組的血氧分壓[MD=2.01,95%CI(1.8,2.23),P0.00001]、血氧飽和度[MD=3.82,95%CI(3.17,4.48),P0.00001]、6分鐘步行距離[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]均顯著升高。肺動(dòng)脈收縮壓[MD=-1.49,95%CI(-1.70,-1.27),P0.00001]、肺動(dòng)脈舒張壓[MD=-1.40,95%CI(-1.52,-1.29),P0.00001]均下降。結(jié)論:阿奇霉素聯(lián)合辛伐他汀能很好改善慢性阻塞性肺疾病合并肺動(dòng)脈高壓患者的血氧分壓、血氧飽和度、6分鐘步行距離、肺功能,降低肺動(dòng)脈壓。
[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.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R563.9;R544.1

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