雾化吸入N-乙酰半胱氨酸治疗急性加重期支气管扩张症患者疗效分析

Efficacy analysis of aerosol inhalation of N-cetylcysteine in the treatment of patients with acute exacerbation of bronchiectasis

目的探讨雾化吸入N-乙酰半胱氨酸(NAC)治疗急性加重期支气管扩张症(支扩)患者的临床疗效及安全性。方法216例急性加重期支扩患者,随机分为A组(110例)和B组(106例)。B组给予0.9%生理盐水8 ml雾化吸入,A组在B组治疗基础上加用NAC雾化治疗。比较两组患者住院时间、再住院率、治疗前后的改良英国医学研究委员会呼吸困难量表(mMRC)评分和咳痰量、出院后1个月内肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC]、临床疗效,记录患者不良反应发生情况。结果A组患者住院时间(8.493±2.762)d短于B组的(9.834±3.116)d,再住院率(0.215±0.047)%低于B组的(0.536±0.165)%,差异均具有统计学意义(P<0.05)。治疗后,A组患者mMRC评分(1.227±0.322)分、咳痰量(9.346±3.279)ml/d均低于B组的(1.562±0.453)分、(15.665±4.932)ml/d,差异均具有统计学意义(P<0.05)。两组患者出院1个月内FEV1、FVC、FEV1/FVC水平比较,差异均无统计学意义(P>0.05)。A组治疗总有效率95.45%高于B组的87.74%,差异具有统计学意义(P<0.05)。结论雾化吸入NAC可显著改善急性加重期支扩患者病情,缩短住院时长,降低出院后半年内再住院率,提高肺功能,安全性高,不良反应少。

Objective To discuss the clinical efficacy and safety of aerosol inhalation of N-cetylcysteine(NAC)in the treatment of patients with acute exacerbation of bronchiectasis.Methods A total of 216 patients with acute exacerbation of bronchiectasis were randomly divided into group A(110 cases)and group B(106 cases).Group B was treated with aerosol inhalation of 0.9%normal saline 8 ml,and group A was treated with NAC atomization therapy on the basis of group B.The hospitalization time,rehospitalization rate,modified British medical research council(mMRC)score and sputum expectoration before and after treatment,pulmonary function[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),FEV1/FVC]within 1 month after discharge,and clinical efficacy were compared between the two groups.The occurrence of adverse reactions of the two groups were recorded.Results The hospitalization time(8.493±2.762)d of group A was shorter than(9.834±3.116)d of group B,and rehospitalization rate(0.215±0.047)%was lower than the(0.536±0.165)%of group B.All the difference was statistically significant(P<0.05).After treatment,the mMRC score(1.227±0.322)points and sputum expectoration(9.346±3.279)ml/d of group A were lower than(1.562±0.453)points and(15.665±4.932)ml/d of group B,and the difference was statistically significant(P<0.05).There was no statistically significant difference in levels of FEV1,FVC and FEV1/FVC within 1 month after discharge between the two groups(P>0.05).The total effective rate 95.45%of group A was higher than 87.74%of group B,and the difference was statistically significant(P<0.05).Conclusion Aerosol inhalation can significantly improve the conditions of disease of patients with acute exacerbation of bronchiectasis,shorten hospitalization time,reduce rehospitalization rate within 6 months after discharge,and improve the pulmonary function of patients with high safety and less adverse reactions.