N-乙酰半胱氨酸辅助治疗对稳定期COPD患者气道炎症、重塑等的调节作用

Regulating effect of N-acetyl cysteine adjuvant therapy on airway inflammation,remodeling and so on in patients with stable COPD

目的:分析N-乙酰半胱氨酸辅助治疗对稳定期COPD患者气道炎症、重塑等的调节作用。方法:将108例在河南省平顶山市第二人民医院治疗的COPD患者纳入研究,经检测均处于稳定期。根据治疗方法不同分为接受常规治疗的对照组58例,加入N-乙酰半胱氨酸辅助治疗的观察组50例。对比两组患者的治疗后血清炎症相关因子、气道重塑指标、Keap1-Nrf2-ARE信号通路、氧化/抗氧化水平等差异。结果:观察组患者的治疗后血清MIP-1α、sTREM-1、IL-13、IL-8、IP-10值均低于对照组患者(P<0.05);观察组患者的治疗后血清TGF-β1、Ang-Ⅱ值低于对照组患者,Ang-Ⅰ值高于对照组患者(P<0.05),病变支气管T、WA、WA%值低于对照组患者(P<0.05);观察组患者的血清及诱导痰中Keap1、Nrf2、ARE值均高于对照组患者(P<0.05);观察组患者的血清MDA、LPO值低于对照组患者,SOD、GSH-Px、T-AOX值高于对照组患者(P<0.05)。结论:稳定期COPD患者接受N-乙酰半胱氨酸辅助治疗,气道炎症及重塑等均得到优化,对于远期病情控制及结局改善等均有积极意义。

Objective：To analyze the regulating effect of N-acetyl cysteine adjuvant therapy on airway inflammation,remodeling and so on in patients with stable COPD.Methods：A total of 108 COPD patients who were treated in our hospital were included for study and were in stable phase after detection.According to different treatment methods,they were divided into control group 58 cases who received routine treatment and observation group 50 cases who received additional N-acetyl cysteine adjuvant therapy.Differences in levels of serum inflammation-related factors,airway remodeling indicators,Keap1-Nrf2-ARE signaling pathway,oxidation-antioxidation levels,etc were compared between two groups after treatment.Results：Serum MIP-1α,sTREM-1,IL-13,IL-8and IP-10 values of observation group after treatment were lower than those of control group（P〈0.05）;serum TGF-β1and Ang-Ⅱ values of observation group after treatment were lower than those of control group,Ang-Ⅰ value was higher than that of control group（P〈0.05）and lesion bronchia T,WA and WA% values were lower than those of control group（P〈0.05）;Keap1,Nrf2 and ARE values in serum and induced sputum of observation group were higher than those of control group（P〈0.05）;serum MDA and LPO values of observation group were lower than those of control group while SOD,GSH-Px and T-AOX values were higher than those of control group（P〈0.05）.Conclusions：Nacetyl cysteine adjuvant therapy for patients with stable COPD optimizes airway inflammation,remodeling and so on,and is of positive significance in controlling long-term disease,improving outcome and so on.