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目的:观察辛伐他汀联合运动训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期合并代谢综合征患者作用。方法:选取120例COPD稳定期合并代谢综合征(metabolism syndrome,MS)为研究对象,随机分为治疗A组、治疗B组及对照组各40例。治疗A组在常规治疗基础上加用辛伐他汀联合运动训练,治疗B组在常规治疗基础上加用辛伐他汀,对照组仅给予常规治疗,观察期为6个月。比较3组患者血清细胞因子白细胞介质(interleukin,IL)-6、IL-8与肿瘤坏死因子-α(tumor necrosis factor,TNF-α),胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA),脉搏波速度(pulse wave velocity,PWV),mMRC及6 min步行距离(6 minutes walking distance,6MWD),并对所获结果进行统计学分析。结果:6个月治疗后:(1)治疗A组及治疗B组的血炎症因子IL-6、IL-8与TNF-α较治疗前及对照组均明显下降,差异有统计学意义(P<0.01);治疗组2组之间比较,A组较B组有明显下降,差异有统计学意义(P<0.05);(2)治疗A组与治疗B组、对照组比较,HOMA有明显下降,差异有统计学意义(P<0.05),但治疗B组与对照组比较,无明显差异(P>0.05);(3)治疗A组、B组与对照组比较,PWV值有明显下降,差异有统计学意义(P<0.05);治疗组2组之间比较,A组较B组PWV值下降,但无明显差异(P>0.05);(4)治疗A组与治疗B组、对照组比较,mMRC及6MWD均明显改善,差异有统计学意义(P<0.05);治疗B组较对照组比较,mMRC及6MWD均明显改善,差异有统计学意义(P<0.05)。结论:辛伐他汀联合运动训练能降低COPD稳定期合并MS的IL-6、IL-8、TNF-α水平;改善胰岛素抵抗及大动脉弹性,并改善患者呼吸困难程度及运动能力。
Objective: To observe the effect of simvastatin combined exercise training on patients with chronic obstructive pulmonary disease (COPD) complicated with metabolic syndrome. Methods: A total of 120 COPD patients with metabolic syndrome (MS) were selected as study subjects and randomly divided into treatment A group, treatment B group and control group 40 cases each. Treatment group A was treated with simvastatin combined with exercise training on the basis of conventional treatment. Group B was given simvastatin on the basis of conventional treatment. The control group was given only routine treatment and the observation period was 6 months. The levels of serum interleukin (IL) -6, IL-8 and tumor necrosis factor-α (TNF-α), homeostasis model assessment of insulin resistance (HOMA) Pulse wave velocity (PWV), mMRC and 6 minutes walking distance (6MWD) were measured and the results were statistically analyzed. Results: After 6 months of treatment, (1) The levels of IL-6, IL-8 and TNF-α in serum of treatment group A and B were significantly lower than those before treatment and control group, with significant difference (P <0.01). There was a significant difference between the two groups in the treatment group (P <0.05). The level of HOMA in the treatment group was significantly lower than that in the B group (P <0.05) (P <0.05), but there was no significant difference between the treatment group B and the control group (P> 0.05); (3) The PWV value of the treatment group A and B group was significantly lower than that of the control group , The difference was statistically significant (P <0.05); between the two treatment groups, the PWV of group A was lower than that of group B, but there was no significant difference (P> 0.05); (4) Compared with the control group, mMRC and 6MWD were significantly improved in the control group (P <0.05). The mMRC and 6MWD in the treatment group B were significantly improved (P <0.05). Conclusion: Simvastatin combined with exercise training can reduce the levels of IL-6, IL-8 and TNF-α in MS with steady-state COPD, improve insulin resistance and aortic elasticity, and improve the degree of dyspnea and exercise capacity in patients.