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目的探讨成人肥胖哮喘患者应用辛伐他汀治疗的效果和安全性。方法 40例成人肥胖哮喘患者,随机分为观察组和对照组各20例,对照组常规吸入布地奈德/福莫特罗干粉吸入剂或沙美特罗/替卡松吸入剂1吸/次,2次/d;观察组在对照组治疗基础上给予辛伐他汀20 mg/次,1次/d,口服。分别于治疗前、治疗第56天评定2组哮喘控制测试(asthma control test,ACT)评分,测定第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC),检测血清瘦素水平,记录治疗期间不良反应发生情况。结果观察组治疗第56天ACT评分(22.60±2.39)、FVC[(2.87±0.47)L]高于治疗前[(18.80±2.93)、(2.27±0.56)L],血清瘦素水平[(11.23±1.12)μg/L]较治疗前[(13.91±1.26)μg/L]下降(P<0.05),FEV1[(1.98±0.60)L]与治疗前[(1.60±0.82)L]比较差异无统计学意义(P>0.05);对照组治疗第56天ACT评分(20.70±2.18)高于治疗前(17.65±3.07)(P<0.05),FEV1[(1.57±0.73)L]、FVC[(2.32±0.38)L]、血清瘦素[(14.93±1.47)μg/L]水平与治疗前[(1.65±0.87)L、(2.28±0.48)L、(14.62±1.50)μg/L]比较差异无统计学意义(P>0.05);观察组治疗后ACT评分、FVC、血清瘦素水平与对照组比较均有统计学意义(P<0.05);治疗期间观察组不良反应发生率(15%)与对照组(10%)比较差异无统计学意义(P>0.05)。结论成人肥胖哮喘患者应用辛伐他汀治疗可改善哮喘症状,提高肺活量,降低血清瘦素水平,且不良反应轻。
Objective To investigate the efficacy and safety of simvastatin in adult obese asthma patients. Methods Forty adults with obese asthma were randomly divided into observation group (20 cases) and control group (20 cases). In the control group, inhalation of budesonide / formoterol powder or salmeterol / 2 times / d; the observation group was given simvastatin 20 mg / time on the basis of the control group, once a day, orally. Two groups of asthma control test (ACT) score were evaluated before treatment and on the 56th day of treatment, respectively. The forced expiratory volume in one second (FEV1), forced vital capacity FVC). Serum leptin levels were measured and adverse reactions were recorded during treatment. Results The ACT score (22.60 ± 2.39) and FVC [(2.87 ± 0.47) L] in the observation group on the 56th day were higher than those before treatment [(18.80 ± 2.93) and (2.27 ± 0.56) (1.98 ± 0.60) L] before treatment compared with [(1.60 ± 0.82) L] before treatment [(13.91 ± 1.26) μg / L] (P> 0.05). The ACT score (20.70 ± 2.18) on the 56th day in the control group was significantly higher than that before treatment (17.65 ± 3.07), P <0.05 2.32 ± 0.38) L, (14.93 ± 1.47) μg / L] were significantly higher than those before treatment [(1.65 ± 0.87) L, (2.28 ± 0.48) L, (14.62 ± 1.50) μg / L] (P> 0.05). The scores of ACT, FVC and serum leptin in the observation group were significantly higher than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was 15% Compared with the control group (10%), there was no significant difference (P> 0.05). Conclusion Simvastatin treatment in obese adults with obesity may improve asthma symptoms, increase lung capacity, lower serum leptin level, and have less adverse reactions.