Effect of 6 Months of Erythromycin Treatment on Inflammatory Cells in Induced Sputum and Exacerbations in Chronic Obstructive Pulmonary Disease
Effect of 6 Months of Erythromycin Treatment on Inflammatory Cells in Induced Sputum and Exacerbations in Chronic Obstructive Pulmonary Disease
复制标题
红霉素治疗 6 个月对慢性阻塞性肺疾病诱发痰中炎症细胞和病情加重的影响
DOI：
10.1159/000321374
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发表时间：
2010-01-01
期刊：
影响因子：
3.7
通讯作者：
Zhong, Xiao-Ning
中科院分区：
文献类型：
--
作者：
He, Zhi-Yi;Ou, Li-Mei;Zhong, Xiao-Ning
背景：慢性阻塞性肺疾病（COPD）以气道炎症为特征，并与急性加重相关。大环内酯类抗生素已被证明在一些慢性气道炎性疾病中表现出抗炎作用。目的：本研究的目的是评估红霉素对COPD患者气道炎症和健康结局的影响。方法：我们进行了为期6个月的随机、安慰剂对照、双盲试验。36例COPD患者随机接受口服红霉素（125 mg，3次/天）或安慰剂治疗。主要结局为痰液中中性粒细胞计数和急性加重。结果：31例患者完成了研究。在治疗结束时，与安慰剂治疗的患者相比，红霉素治疗组的痰中中性粒细胞计数显著降低（p = 0.005）。与安慰剂组相比，红霉素治疗组的痰液中的总细胞和痰液上清液中的中性粒细胞弹性蛋白酶也显著降低（分别为p = 0.021和p = 0.024）。红霉素组的平均急性加重率低于安慰剂组（相对风险= 0.554，p = 0.042）。Kaplan-Meier生存分析显示，与安慰剂相比，红霉素显著延迟至首次COPD加重的时间（p = 0.032）。结论：红霉素治疗COPD患者可以减轻气道炎症和减少急性加重，因此可能有助于COPD的管理。
Background: Chronic obstructive pulmonary disease (COPD) is characterized by airway inflammation and is associated with acute exacerbations. Macrolide antibiotics have been shown to exhibit anti-inflammatory effects in some chronic airway inflammatory diseases. Objective: The aim of this study was to assess the effect of treatment with erythromycin on airway inflammation and health outcome in COPD patients. Methods: We conducted a randomized, placebo-controlled, double-blind trial of erythromycin for a period of 6 months. Thirty-six COPD patients were randomized to treatment with oral erythromycin (125 mg, three times/day) or placebo. The primary outcomes were neutrophil number in sputum and exacerbations. Results: Thirty-one patients completed the study. At the end of treatment, neutrophil counts in the sputum were significantly decreased in the group treated with erythromycin compared with placebo-treated patients (p = 0.005). Total cells in the sputum and neutrophil elastase in sputum supernatant were also significantly decreased in those treated with erythromycin compared with the placebo group (p = 0.021 and p = 0.024, respectively). The mean exacerbation rate was lower in the erythromycin group than in the placebo group (relative risk = 0.554, p = 0.042). Kaplan-Meier survival analysis showed that erythromycin significantly delayed the time to the first COPD exacerbation compared with placebo (p = 0.032). Conclusions: Erythromycin treatment in COPD patients can reduce airway inflammation and decrease exacerbations and may therefore be useful in the management of COPD.