乙酰半胱氨酸泡腾片治疗慢性阻塞性肺疾病合并肺气肿对患者α1-抗胰蛋白、内皮素-1、炎症因子水平的影响

EFFECT OF B-CYSTEINE EFFERVESCENT TABLETS ON LEVEL OFα1-AT,ET-1 AND INFLAMMATORY FACTORS IN PATIENTS WITH COPD COMBINED WITH EMPHYSEMA

目的观察乙酰半胱氨酸泡腾片治疗慢性阻塞性肺疾病(COPD)合并肺气肿对患者α1-抗胰蛋白酶(α1-AT)、内皮素-1(ET-1)、炎症因子水平的影响,为临床治疗提供参考。方法选取西南医科大学附属成都363医院2017年7月—2019年7月收治的COPD合并肺气肿患者96例,根据治疗方法的不同分为二组,每组48例。对照组给予常规对症治疗,观察组在对照组基础上给予乙酰半胱氨酸泡腾片治疗。记录二组治疗前后血气指标、肺功能指标、炎症因子、α1-AT、ET-1水平及COPD患者自我评估测试问卷(CAT)评分变化,统计二组临床治疗总有效率。结果观察组总有效率(89.58%)高于对照组(72.92%),差异有统计学意义(P<0.05)。治疗后,二组动脉血氧分压(PaO_(2))、血氧饱和度(SpO_(2))、α1-AT、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)水平较治疗前上升,动脉血二氧化碳分压(PaCO_(2))、白细胞介素-18(IL-18)、C反应蛋白(CRP)、ET-1水平及CAT评分较治疗前下降,观察组PaO_(2)、SpO_(2)、α1-AT、FEV1、FVC水平均高于对照组,PaCO_(2)、IL-18、CRP、ET-1水平及CAT评分均低于对照组(均P<0.05)。结论乙酰半胱氨酸泡腾片治疗COPD合并肺气肿可调节患者血清α1-AT、ET-1及炎症因子的表达,改善血气指标,提高疗效。

Objective To observe the effect of acetylcystine effervescent tablets onα1-antitrypsin(α1-AT),et-1(ET-1)and inflammatory factors in patients with chronic obstructive pulmonary disease((COPD))complicated with emphysema,so as to provide reference for clinical treatment.Methods Ninety six patientswith COPD combined with emphysema were selected from July 2017 to July 2019 in the 363 Chengdu Hospital Affiliated to Southwest Medical University,the different treatment methods were divided into 2 groups,each group of 48 cases.The control group was given the routine symptomatic treatment,and the observation group was given the treatment of the B-cysteine effervescent tablet on the basis of the control group.The blood gas index,the pulmonary function index,the inflammatory factor,the levelα1-AT,the ET-1 level and the self-assessment test questionnaire(CAT)score of the patients with COPD were recorded in the 2 groups before and after treatment,and the total effective rate of the 2 groups of clinical treatment was counted.Results The total effective rate(89.58%)in the observation group was higher than that in the control group(72.92%),and the difference was statistically significant(P<0.05).After treatment,arterial partial pressure of oxygen(PaO_(2)),oxygen saturation(SpO_(2)),α1-AT,forced expiratory volume(FEV1)at the first second,forced vital capacity(FVC)increased,arterial blood carbon dioxide partial pressure(PaCO_(2)),interleukin-18(IL-18),C-reactive protein(CRP),ET-1 and CAT scores decreased.The levels of PaO_(2),SpO_(2),α1-AT,FEV1 and FVC were higher than that in the group,and the levels of PaCO_(2),IL-18,CRP,ET-1 and CAT were lower than that in the control group(P<0.05).Conclusion The treatment COPD acetylcysteine effervescent tablets combined with emphysema can regulate the expression of serumα1-AT、ET-1 and inflammatory factors,improve blood gas index and improve the curative effect.