N-乙酰半胱氨酸联合法舒地尔治疗老年慢性阻塞性肺疾病相关肺动脉高压的效果观察

Effect of N-acetylcysteine Combined with Fasudil on Pulmonary Artery Hypertension Related to Chronic Obstructive Pulmonary Disease in the Elderly

目的观察N-乙酰半胱氨酸联合法舒地尔治疗慢性阻塞性肺疾病相关肺功能高压的效果,评价其临床应用价值。方法选择60例慢阻肺相关肺动脉高压患者,使用随机数字表法将其分为法舒地尔治疗的对照组和N-乙酰半胱氨酸联合法舒地尔治疗的观察组,每组30例。比较2组患者的动脉血气、IL-1、IL-6、ET-1以及肺动脉压力情况。结果与治疗前比较,治疗后2组PaCO_2、PaO_2和氧合指数指标均显著改善,且观察组改善均明显优于对照组(均P<0.05);治疗后2组IL-1、IL-6和ET-1水平均明显降低,且观察组降低比对照组更为显著(均P<0.05)。治疗后观察组PSBP和PDBP值均明显降低,且降低程度明显优于对照组(均P<0.05)。结论慢性阻塞性肺疾病相关肺动脉高压,采用N-乙酰半胱氨酸与法舒地尔联合治疗较单用法舒地尔治疗临床效果较佳。

Objective To observe the effect of N-acetylcysteine combined with fasudil on pulmonary artery hyper-tension related to chronic obstructive pulmonary disease （COPD） in the elderly and to evaluate the clinical application value. Methods 60 patients with COPD-related pulmonary artery hypertension were selected and randomly divided into 2 groups： control group （fasudil） and observation group （N-acetylcysteine combined with fasudil）, 30 in each; a comparative analysis was made to arterial blood gas, interleukin-1 （IL-1）, interleukin-6 （IL-6）, ET-1, and pulmonary artery pressure of the patients between the 2 groups. Results After treatment, the PaCO2, PaO2, and oxygenation index of the patients in both groups were obviously improved while the improvement in observation group was superior to those in control group （P〈0.05）; the levels of IL-1, IL-6, ET-1 and the values of PSBP and PDBP in both groups decreased after treatment and the decreases in observation group were more significant than those in control group （P〈0.05）. Conclusions The application of N-acety- lcysteine combined with fasudil in patients with COPD-related pulmonary artery hypertension is of better clinical effect than single application of fasudil.