乙酰半胱氨酸溶液雾化吸入对COPD患者免疫功能及肺功能的影响

Effects of aerosol inhalation of acetylcysteine solution on immune and lung function of patients with COPD

目的研究乙酰半胱氨酸溶液雾化吸入对慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)患者细胞因子、免疫指标及肺功能的影响。方法随机抽取我院呼吸科2016年1月至2018年1月收治的105例COPD患者,对照组52例,给予氧疗、平喘、抗感染、BIPAP辅助通气等常规治疗;观察组53例,在对照组基础上,雾化吸入3 ml乙酰半胱氨酸溶液,2次/d。两组均连续治疗14 d。比较两组患者临床疗效,治疗前后血清细胞因子水平、T淋巴细胞亚群水平、肺功能与CAT评分。结果观察组的总有效率明显高于对照组(χ^2=6.20,P<0.05)。治疗后14 d,观察组血清TNF-α、IL-6、IL-8水平均低于对照组;观察组血清CD3^+、CD4^+、CD4^+/CD8^+低于对照组,CD8^+高于对照组;观察组FVC、FEV1、FEV1/FVC高于对照组,CAT评分低于对照组。差异均有统计学意义(P<0.05)。结论乙酰半胱氨酸溶液雾化吸入能够有效减轻COPD患者炎性反应状态,改善患者免疫功能,可能通过协同作用提升患者呼吸功能及治疗效果。

Objective To study the effects of aerosol inhalation of acetylcysteine solution on cytokines,immune indexes and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Methods Totally 105 patients with COPD in our hospital were randomly selected from January 2016 to January 2018.Control group(n=52) was treated with oxygen therapy,asthma relief and BIPAP assisted ventilation,in addition,observation group(n=52) inhaled 3 ml acetylcysteine solution twice daily.Both groups were treated continuously for 14 d.The clinical efficacy,serum cytokine level and T lymphocyte subsets,pulmonary function and CAT score were compared between the two groups.Results The total effective rate of observation group was higher than that of control group(χ~2=6.20,P<0.05).The levels of serum IL-6,IL-8 and TNF-α in observation group were lower than those in control group at 14 d after treatment(P<0.05).The serum levels of CD3^+,CD4^+ and CD4^+/CD8^+ in observation group were lower than those in control group(P<0.05),while CD8^+ was higher than that in control group(P<0.05).The FVC,FEV1 and FEV1/FVC in observation group were significantly higher than those in control group(P<0.05),while the CAT score was lower than that in control group(P<0.05).Conclusion Aerosol inhalation of acetylcysteine solution can effectively reduce the inflammatory reaction state and improve the immune function of patients with COPD.It may enhance the respiratory function and therapeutic effect of patients with COPD by synergistic effect.