乙酰半胱氨酸胶囊联合沙美特罗替卡松在COPD合并肺结核患者中的应用价值

Application value of acetylcysteine capsule combined with salmeterol and fluticasone propionate on patients with COPD and pulmonary tuberculosis

目的探讨乙酰半胱氨酸胶囊联合沙美特罗替卡松在慢性阻塞性肺疾病(COPD)合并肺结核患者中的应用价值,分析可溶性白细胞介素-2受体(sIL-2R)水平及免疫功能变化。方法选取2021年8月-2022年9月于湘南学院附属医院收治的98例COPD合并肺结核患者为研究对象,使用随机数字表法,分为观察组(n=49)和对照组(n=49)。对照组予以常规药物治疗,观察组在对照组基础上予以乙酰半胱氨酸胶囊联合沙美特罗替卡松治疗。分析两组患者总有效率差异,比较两组患者治疗前、治疗3个月后炎症介质[sIL-2R、淀粉样蛋白a(SAA)、干扰素-γ(IFN-γ)]、免疫功能(CD4、CD8、CD4/CD8)、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、一氧化碳弥散量(DLCO)]水平差异,观察两组患者治疗期间的不良反应情况。结果治疗3个月后,观察组治疗总有效率为95.92%,高于对照组的83.67%,差异有统计学意义(χ^(2)=4.009,P<0.05)。治疗后两组sIL-2R、SAA、IFN-γ、CD8水平较治疗前降低,且观察组上述指标低于对照组,差异均有统计学意义(P均<0.05)。治疗后两组CD4、CD4/CD8、FVC、FEV1、DLCO水平均较治疗前上升,且观察组上述指标高于对照组,差异均有统计学意义(P均<0.05)。治疗期间,两组患者不良反应差异无统计学意义(χ^(2)=0.102,P>0.05)。结论乙酰半胱氨酸胶囊联合沙美特罗替卡松有助于COPD合并肺结核患者提升临床疗效,且对sIL-2R、免疫功能、肺功能的调节效果更显著。

Objective To explore the application value of acetylcysteine capsule combined with salmeterol and fluticasone propionate on patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary tuberculosis based on the changes of soluble interleukin-2 receptor(sIL-2R)and immune function.Methods A total of 98 patients with COPD and pulmonary tuberculosis admitted to the Affiliated Hospital of Xiangnan University from August 2021 to September 2022 were selected as research subjects,and were divided into observation group(n=49)and control group(n=49)by using the random number table method.The control group was given conventional drug treatment,and the observation group was given acetylcysteine capsule combined with salmeterol and fluticasone propionate on the basis of the control group.The total effective rate in the two groups was analyzed after treatment.Inflammatory mediators[sIL-2R,serum amyloid a(SAA),interferon-γ(IFN-γ)],immune function(CD4,CD8,CD4/CD8)and pulmonary function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),diffusing capacity for lung carbon monoxide(DLCO)]were compared between the two groups before treatment and after 3 months of treatment.The differences in adverse reactions were explored in the two groups during treatment.Results After 3 months of treatment,the total effective rate of treatment in observation group(95.92%)was higher than that in control group(83.67%)(χ^(2)=4.009,P<0.05).After treatment,sIL-2R,SAA,IFN-γ,and CD8 levels decreased in the two groups compared with those before treatment,and the above indexes in the observation group were lower than those in the control group(all P<0.05),and the CD4,CD4/CD8,FVC,FEV1 and DLCO levels in the two groups were enhanced compared to before treatment,and the above indexes in observation group were higher than those in control group(all P<0.05).During treatment,there were no significant differences in adverse reactions between the two groups(χ^(2)=0.102,P>0.05).Conclusion Acetylcysteine capsule combined with salmeterol and fluticasone propionate could improve the clinical efficacy in patients with COPD and pulmonary tuberculosis,and it had a significant regulation effect on sIL-2R,immune function and pulmonary function.