乙酰半胱氨酸联合特布他林雾化液治疗COPD的临床疗效及其对血清炎性因子的影响

Clinical efficacy of acetylcysteine combined with terbutaline nebulizer in treating COPD and its effect on serum inflammatory factors

目的:探讨乙酰半胱氨酸联合特布他林雾化液治疗慢性阻塞性肺疾病(COPD)的临床疗效及其对血清炎性因子的影响。方法:选取186例COPD急性加重期患者为研究对象,依据治疗方式不同分为观察组和对照组,每组各93例。对照组患者在常规治疗基础上给予特布他林雾化液治疗,观察组患者在对照组基础上给予口服乙酰半胱氨酸片治疗,疗程均为10 d;比较两组患者疗效、不良反应、血清炎性因子、氧化应激因子及肺功能。结果:观察组患者临床治疗总有效率高于对照组(P<0.05),住院时间短于对照组(P<0.05)。治疗后,观察组患者血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)、IL-10、可溶性髓系细胞触发受体-1(sTREM-1)、丙二醛(MDA)及晚期蛋白氧化产物(AOPP)水平低于对照组(P<0.05),超氧化物歧化酶(SOD)水平高于对照组(P<0.05);两组患者第1秒用力呼气容积占预计值百分比(FEV_1%pred)、呼气流量峰值(PEF)及第1秒用力呼气容积占用力肺活量百分比(FEV_1/FVC)升高(P<0.05),且观察组高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:乙酰半胱氨酸联合特布他林雾化液治疗COPD的疗效肯定,且可改善炎性因子及氧化应激指标,促进患者肺功能的恢复,有推广应用价值。

Objective:To explore the clinical efficacy of acetylcysteine combined with terbutaline nebulizer in the treatment of COPD and its influence on serum inflammatory factors.Methods:186 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into observation group(n=93)and control group(n=93)according to different treatment methods.The control group was given terbutaline nebulizer liquid on the basis of conventional treatment,the observation group was treated with oral acetylcysteine tablets on the basis of the control group,the course of treatment was 10 days.The efficacy,adverse reactions,serum inflammatory factors,oxidative stress factors and lung function were compared between the two groups.Results:The total effective rate of clinical treatment in the observation group was higher than that in the control group(P<0.05),the hospital stay in the observation group was shorter than the control group(P<0.05).After treatment,the levels of serum CRP,TNF-α,IL-8,IL-10,sTREM-1,MDA and AOPP in the observation group were significantly lower than those in the control group(P<0.05),the serum SOD in the observation group was higher than that in the control group(P<0.05).Compared with the control group,the detection values of FEV 1%pred,PEF and FEV 1/FVC in the observation group increased significantly after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Acetylcysteine combined with terbutaline nebulizer has definite curative effect in the treatment of COPD,and can improve inflammatory factors and oxidative stress indicators,promote the recovery of lung function,which has the value of popularization and application.