乙酰半胱氨酸联合沙美特罗替卡松治疗COPD急性加重期患者的效果

Effects of Acetylcysteine combined with Salmeterol fluticasone in treatment of patients with acute exacerbation of COPD

目的:观察乙酰半胱氨酸联合沙美特罗替卡松治疗慢性阻塞性肺疾病(COPD)急性加重期患者的效果。方法:选取86例COPD急性加重期患者为研究对象,按随机数字表法分为对照组与观察组各43例。对照组采用沙美特罗替卡松吸入粉雾剂治疗,观察组在对照组基础上联合乙酰半胱氨酸颗粒治疗,比较两组治疗前后氧化应激指标[超氧化物歧化酶(SOD)、丙二醛、谷胱甘肽]水平、炎性因子[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)]水平、肺功能指标[用力肺活量(FVC)、最大呼气峰流速(PEF)、第1秒用力呼气容积(FEV_(1))/FVC]水平和不良反应发生率。结果:治疗后,观察组SOD、谷胱甘肽水平均高于对照组,丙二醛水平低于对照组,差异有统计学意义(P<0.05);观察组TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05);观察组FVC、PEF、FEV_(1)/FVC水平均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:乙酰半胱氨酸联合沙美特罗替卡松治疗COPD急性加重期患者可提高肺功能指标水平,降低炎性因子水平,以及改善氧化应激指标水平,其效果优于单纯沙美特罗替卡松治疗。

Objective:To observe effects of Acetylcysteine combined with Salmeterol fluticasone in treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:86 patients with acute exacerbation of COPD were selected as the research objects and were divided into control group and observation group according to the random number table method,43 cases in each group.The control group was treated with Salmeterol fluticasone aerosol,while the observation group was treated with Acetylcysteine granules on the basis of that of the control group.The levels of antioxidant stress indicators[superoxide dismutase(SOD),malondialdehyde,glutathione],the inflammatory factor levels[tumor necrosis factor(TNF-α),interleukin-6(IL-6)],the pulmonary function indicator levels[forced vital capacity(FVC),peak expiratory flow(PEF),forced expiratory volume in 1 second(FEV_(1))/FVC]and incidence of adverse reactions were compared between the two groups before and after the treatment.Results:After the treatment,the levels of SOD and glutathione in the observation group were higher than those in the control group;the level of malondialdehyde was lower than that in the control group;and the differences were statistically significant(P<0.05).The levels of TNF-α and IL-6 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of FVC,PEF and FEV_(1)/FVC in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Acetylcysteine combined with Salmeterol fluticasone in the treatment of the patients with acute exacerbation of COPD can improve the levels of pulmonary function indicator,reduce the levels of inflammatory factor indexes,and improve the levels of antioxidant stress indicators.Moreover,it is superior to single Salmeterol fluticasone treatment.