Azithromycin Combined With Simvastatin In The Treatment Of Chronic Obstructive Pulmonary Disease Complicated With Pulmonary Hypertension:a Meta-analysis

Objective:Pulmonary hypertension is one of the common complications and the main causes of death in patients with chronic obstructive pulmonary disease,the treatment effect is not good.Studies suggest that Azithromycin combined with simvastatin is effective in the treatment of COPD with pulmonary hypertension,but there is no relevant evidence of evidence-based medicine.This study intends to search the relevant literature at home and abroad,using Meta analysis to explore the efficacy of Azithromycin combined with simvastatin,to provide evidence for clinical treatment.Methods:We searched PubMed、EMbase、The Cochrane Library(Issue 1,2017)、VIP、CBM、CNKI and WangFang Dtabase to collect randomized controlled trials(RC Ts)about azithromycin combined with simvastatin in the treatment of chronic obstructive pulmonary disease with pulmonary hypertension,and the time was limited to January 2017.The literature using the Cochrane collaboration recommended assessment tools was used to evaluate the quality.Date analysis was performed by RevMan5.2 software.Results:A total of 9 RCT patients were enrolled in the study,included 792 patients.The results of meta-analysis showed that,Compared with control group.The partial pressure of oxygen[MD=2.01,95%CI(1.8,2.23),P<0.00001]、blood oxygen saturation [MD=3.82,95%CI(3.17,4.48),P<0.00001]、6 minutes walking distance [MD=75.03,95%C I(70.48,79.58),P<0.00001]、FEV1[MD= 0.27,95%CI(0.25,0.28),P<0.00001]、FVC[MD= 0.36,95%CI(0.33,0.38),P<0.00001]were significantly higher in the observation group.Pulmonary artery systolic pressure[MD=-0.99,95%CI(-1.1,-0.89),P < 0.00001)],pulmonary artery diastolic pressure [MD=-1.40,95%CI(-1.52,-1.29),P < 0.00001)decreased.Conclusion:Azithromycin combined with simvastatin can improve the oxygen partial pressure,oxygen saturation,6 minutes walking distance,pulmonary function and decrease the pulmonary arterial pressure in patients with chronic obstructive pulmonary disease and pulmonary hypertension.