N-乙酰半胱氨酸联合沙丁胺醇对COPD并呼吸衰竭患者的效果观察

Curative effect of N-acetylcysteine combined with salbutamol on COPD complicated by respiratory failure

目的探究N-乙酰半胱氨酸联合沙丁胺醇治疗慢性阻塞性肺疾病(COPD)并呼吸衰竭的效果。方法抽取2020年5月至2022年4月信阳市第四人民医院收治的COPD并呼吸衰竭患者90例,按照随机数表法分成对照组与研究组,每组45例。对照组予以沙丁胺醇治疗,研究组予以N-乙酰半胱氨酸联合沙丁胺醇治疗,均持续治疗2周。比较两组治疗前后的血清相关因子和肺功能、呼吸功能变化,并进行安全性评估。结果治疗后,两组血清白细胞介素-6、C-反应蛋白、肿瘤坏死因子-α、肌酸激酶同工酶水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组最大通气量、第1秒用力呼气容积及用力肺活量均高于治疗前,且研究组高于对照组(P<0.05);两组气道吸气峰压、平台压及气道平均压均低于治疗前,且研究组低于对照组(P<0.05)。研究组不良反应发生率(11.11%,5/45)与对照组(8.89%,4/45)比较差异未见统计学意义(P>0.05)。结论N-乙酰半胱氨酸联合沙丁胺醇治疗COPD并呼吸衰竭,能更好地降低患者的血清炎症因子水平,改善其心肌损伤,促进肺功能与呼吸功能恢复,且安全性较高。

Objective To investigate the efficacy of N-acetylcysteine combined with salbutamol in the treatment of chronic obstructive pulmonary disease(COPD)complicated by respiratory failure.Methods A total of 90 patients with COPD complicated by respiratory failure admitted to the Xinyang Fourth People’s Hospital from May 2020 to April 2022 were selected,and they were divided into control group and study group by random number table method,with 45 patients in each group.The control group was treated with salbutamol,while the study group was treated with N-acetylcysteine combined with salbutamol.Both groups were treated for 2 weeks.The changes of serum related factors,pulmonary function and respiratory function were compared between the two groups before and after treatment,moreover,the safety was evaluated.Results After treatment,the levels of interleukin-6,C-reactive protein,tumor necrosis factor-αand creatine kinase isoenzyme in both groups were significantly lower than those before treatment,and these indexes in the study group were significantly lower than those in the control group(P<0.05).After treatment,the maximum ventilation volume,forced expiratory volume in 1 second and forced vital capacity of the two groups were higher than those before treatment,and the three indexes in the study group were higher than those in the control group(P<0.05).After treatment,the peak inspiratory pressure,plateau pressure and mean airway pressure in both groups were lower than those before treatment,and these indexes in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the study group(11.11%,5/45)and the control group(8.89%,4/45),P>0.05.Conclusions N-acetylcysteine combined with salbutamol in the treatment of COPD complicated by respiratory failure can better reduce the level of serum inflammatory factors,alleviate myocardial injury,and promote the recovery of lung function and respiratory function,with high safety.