乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者炎性反应、肺功能的影响

Effect of acetylcysteine granules combined with ambroxol hydrochloride injections on inflammatory response and pulmonary function in patients with chronic obstructive pulmonary disease

目的探究乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者炎性反应、肺功能的影响。方法选取2021年7月至2022年12月收治的COPD患者80例,随机数字表法将其分为盐酸氨溴索组和联合组,每组40例,盐酸氨溴索组患者使用盐酸氨溴索注射液治疗,联合组患者使用乙酰半胱胺酸颗粒联合盐酸氨溴索注射液治疗。检测2组患者肺功能[第1秒用力呼气容积(FEV_(1))/FEV_(1)预计值(FEV_(1)/preFEV_(1))、FEV_(1)/占用力肺活量比值(FEV_(1)/FVC)]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(paCO_(2))]水平,对2组免疫功能、炎性反应[C-反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]、氧化应激[超氧化物歧化酶(SOD)、总抗氧化能力(TAOC)]反应指标进行检测,对比2组治疗效果、不良反应发生情况。结果治疗后,联合组患者FEV1/preFEV1、FEV1/FVC水平高于盐酸氨溴索组(P<0.05)。治疗后,联合组患者PaO_(2)水平高于盐酸氨溴索组,PaCO_(2)水平低于盐酸氨溴索组(P<0.05)。治疗后,联合组患者CD4^(+)、CD4^(+)/CD8^(+)水平高于盐酸氨溴索组,CD8^(+)低于盐酸氨溴索组(P<0.05)。治疗后,联合组患者CRP、TNF-α水平低于盐酸氨溴索组(P<0.05)。治疗后,联合组SOD水平高于盐酸氨溴索组,TAOC水平低于盐酸氨溴索组(P<0.05)。联合组患者治疗有效率高于盐酸氨溴索组(P<0.05)。联合组患者不良反应发生率略高于盐酸氨溴索组,但差异无统计学意义(P>0.05)。结论使用乙酰半胱胺酸颗粒联合盐酸氨溴索注射液对COPD患者进行治疗,能够改善患者肺功能、血气指标水平,改善患者免疫功能,减轻患者炎性反应、氧化应激反应严重程度,治疗效果显著。

Objective To explore the effect of acetylcysteine granules combined with ambroxol hydrochloride injections on inflammatory response and pulmonary function in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 80 COPD patients admitted to our hospital from July 2021 to December 2022 were randomly divided into ambroxol hydrochloride group(40 cases)and combination group(40 cases)by random number table method.Patients in the ambroxol hydrochloride group were treated with ambroxol hydrochloride injections,and those in the combination group were treated with acetyl cysteamine granules combined with ambroxol hydrochloride injection.Pulmonary function(ratio of the forced expiratory volume within the first second to the predicted value[FEV1/preFEV1],ratio of FEV1 to the forced vital capacity[FEV1/FVC]),blood gas(partial pressure of oxygen[PaO_(2)],partial pressure of carbon dioxide[PaCO_(2)]),immune function,inflammatory response(C-reactive protein[CRP],tumor necrosis factor alpha[TNF-α])and oxidative stress(superoxide dismutase[SOD],total antioxidant capacity[TAOC])were compared between groups.Efficacy and adverse events were compared as well.Results After treatment,FEV1/preFEVl and FEV1/FVC in combination group were significantly higher than those of ambroxol hydrochloride group(P<0.05).After treatment,significantly higher PaO_(2) and significantly lower PaCO_(2) were detected in combination group than those of ambroxol hydrochloride group(P<0.05).After treatment,significantly higher CD4^(+)and CD4^(+)/CD8^(+),and significantly lower CD8^(+)were detected in combination group than those of ambroxol hydrochloride group(P<0.05).After treatment,CRP and TNF-αwere significantly lower in combination group than those of ambroxol hydrochloride group(P<0.05).After treatment,significantly higher SOD and significantly lower TAOC were detected in combination group than those of ambroxol hydrochloride group(P<0.05).Significantly higher efficacy was detected in combination group than that of ambroxol hydrochloride group(P<0.05).The incidence of adverse events in combination group was slightly higher than that of ambroxol hydrochloride group without a significant difference(P>0.05).Conclusion The combination of acetyl cysteamine granules and ambroxol hydrochloride injections can improve the pulmonary function,blood gas and immune function,and alleviate inflammatory response and oxidative stress in COPD patients with an excellent efficacy.