N-乙酰半胱氨酸治疗慢性阻塞性肺疾病的对照研究

A Control Study of N-acetylcysteine Therapy for Chronic Obstructive Pulmonary Disease

目的通过观察N-乙酰半胱氨酸(NAC)治疗对慢性阻塞性肺疾病(COPD)患者稳定期血浆肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)与肺功能的影响,以评价NAC对COPD的治疗作用。方法选择COPD患者65例,随机分为试验组和对照组,两组患者均接受COPD的常规药物治疗且所有药物均维持原剂量不变;试验组在对照组基础上加服N-乙酰半胱氨酸泡腾片(NAC)600mg,qd,共治疗8周。分别测定两组治疗前及治疗后血浆TNF-α、hs-CRP浓度及PaO2、PaCO2水平和肺功能水平。结果 NAC治疗8周后,试验组血浆TNF-α、hs-CRP浓度及PaO2PaCO2水平较对照组改善有统计学意义(P<0.05);试验组肺功能分级明显改善,较对照组肺功能改善有统计学意义(P<0.05)。结论 NAC治疗能降低COPD患者血浆TNF-α、hs-CRP浓度;改善PaO2、PaCO2水平及肺功能分级。

ObjectiveNAC therapy was used to observe the effect of TNF-α,hs-CRP,PaO2,PaCO2and lung function in patients with COPD,so as to evaluate the therapeutic effect. Methods65 patients with COPD were recruited and the patients were randomly divided into 2 treatment groups：control group （n=31） and experimental group （n=34）. Patients in the two groups received the conventional treatment of COPD in unchanged dosage for the duration of the study except stopping using antibotic drug after infection was resolved. NAC tablets were taken orally at a dose of 600mg once a day in experimental group. After 8 weeks treatment, we appraised lung function and the plasma level of TNF-α,hs-CRP,PaO2 and PaCO2. ResultsCompared with normal controls, the plasma levels of TNF-α and hs-CRP increased significantly. The higher level of those , the higher lung function class was in 65 COPD patients,and there was significant effect（P〈0.05）.The same improvement was seen at the level of PaO2 and PaCO2. ConclusionThe treatment with NAC decreases the levels of plasma TNF-α,hs-CRP and PaO2 and improves the levels of PaCO2 in patients witn COPD. NAC improves lung function in patients of COPD.