2018 年第 7 期 第 13 卷

乙酰半胱氨酸对慢性阻塞性肺疾病急性加重期患者肺功能和血清炎性因子及抗氧化指标水平的影响

Effect of acetylcysteine on pulmonary function, serum inflammatory factors and antioxidant indexes in patients with acute exacerbation of chronic obstructive pulmonary disease

作者：张林范晓东许红阳

英文作者：

单位：214023江苏省无锡市人民医院急诊科（张林），呼吸科（范晓东），重症医学科（许红阳）

英文单位：

关键词：慢性阻塞性肺疾病；乙酰半胱氨酸；肺功能；高敏C反应蛋白；降钙素原

英文关键词：

• 摘要：

• 【摘要】目的    探究乙酰半胱氨酸对慢性阻塞性肺疾病（COPD）急性加重期患者肺功能、血清炎性因子及抗氧化指标水平的影响。方法    选取江苏省无锡市人民医院2015年9月至2017年9月收治的COPD急性加重期患者154例。按照随机数字表法分为对照组和观察组，各77例。对照组行COPD常规治疗，观察组在对照组基础上辅以乙酰半胱氨酸600 mg/次，1～2次/d口服治疗，2组均治疗1周。比较2组治疗前后肺功能［用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC）］、血清炎性指标［高敏C反应蛋白（hs-CRP）、降钙素原］及抗氧化指标［丙二醛、超氧化物歧化酶（SOD）、谷胱甘肽］水平。结果    治疗后观察组FVC、FEV1、FEV1/FVC指标均高于对照组［（2.87±0.22）L比（2.64±0.54）L、（2.65±0.33）L比（1.71±0.45）L、（67±7）%比（59±7）%］，差异均有统计学意义（均P＜0.05）。治疗后观察组血清hs-CRP、降钙素原水平均低于对照组［（4.6±2.4）mg/L比（9.4±3.8）mg/L、（0.31±0.26）μg/L比（0.92±0.55）μg/L］，差异均有统计学意义（均P＜0.05）。治疗后观察组丙二醛水平低于对照组，SOD、谷胱甘肽水平高于对照组［（4.1±0.6）μmol/L比（7.3±0.7）μmol/L、（82±7）μg/L比（71±7）μg/L、（162±12）U/L比（128±13）U/L］，差异均有统计学意义（均P＜0.05）。结论    乙酰半胱氨酸应用于COPD急性加重期患者治疗中可有效改善其肺功能，提高机体抗氧化水平，抑制炎症反应，促进肺功能恢复。

• 【Abstract】Objective    To investigate the effect of acetylcysteine on pulmonary function, serum inflammatory factors and antioxidant indexes in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods    A total of 154 patients with acute exacerbation of COPD admitted from September 2015 to September 2017 in Wuxi People′s Hospital were randomly divided into control group and observation group, with 77 cases in each group. The control group were treated with conventional therapy; the observation group took acetylcysteine 600 mg/time, 1-2 times/d on the basis of conventional therapy for 1 week. Lung function indexes［forced vital capacity(FVC), forced expiratory volume in 1 second(FEV1), FEV1/FVC］, serum inflammatory factors［high-sensitivity C-reactive protein(hs-CRP), procalcitonin］ and antioxidant indexes［malondialdehyde, superoxide dismutase(SOD), glutathione］ were analyzed before and after treatment. Results    After treatment, FVC, FEV1 and FEV1/FVC in observation group were significantly higher than those in control group［（2.87±0.22）L vs （2.64±0.54）L, （2.65±0.33）L vs （1.71±0.45）L,（67±7）% vs （59±7）%］(P<0.05); serum levels of hs-CRP and procalcitonin in observation group were significantly lower than those in control group［（4.6±2.4）mg/L vs （9.4±3.8）mg/L, （0.31±0.26）μg/L vs （0.92±0.55）μg/L］(P<0.05); serum level of malondialdehyde in observation group was significantly lower, serum levels of SOD and glutathione were significantly higher than those in control group［（4.1±0.6）μmol/L vs （7.3±0.7）μmol/L, （82±7）μg/L vs （71±7）μg/L, （162±12）U/L vs （128±13）U/L］(P<0.05). Conclusion    Acetylcysteine treating acute exacerbation of COPD can effectively inhibit inflammatory response, increase antioxidation and improve pulmonary function recovery.

  【Key words】Chronic obstructive pulmonary disease;Acetylcysteine;Pulmonary function;High-sensitivity C-reactive protein;Procalcitonin

  【Fund program】Scientific Research Project of Jiangsu Provincial Commission of Health and Family Planning (BJ15009)