摘要
目的研究乙酰半胱氨酸对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmo⁃nary disease,AECOPD)患者气道重塑、肺功能及血清肺表面活性蛋白-A(surfactant protein A,SP-A)、肺表面活性蛋白-D(lung surfactant protein-D,SP-D)水平的影响。方法选取医院收治的80例AECOPD患者,随机分为常规组(采用常规对症治疗)和研究组(在常规治疗的基础上使用乙酰半胱氨酸辅助治疗),每组各40例。评定疗效,观察治疗前、治疗4周后两组气道重塑指标、肺功能指标及克拉拉细胞蛋白(clara cell protein 16,CCl6)、SP-A、SP-D水平变化,记录不良反应发生情况。结果研究组治疗总有效率(85.00%)高于常规组(65.00%),(χ2=4.267,P=0.039);治疗前,常规组和研究组气道重塑相关指标、肺功能指标、CCl6、SP-A、SP-D水平比较差异均无统计学意义(P>0.05);治疗4周后,研究组气道壁厚度与气道管腔外径比值(ratio of airway wall thickness to airway lumen outer diameter,T/D)、气道壁面积(airway wall area,WA)、WA占总截面积百分比(airway wall area as a percentage of total cross-sectional area,WA%)低于常规组,气道腔面积(airway cavity area,AI)指标高于常规组(P<0.05),两组第一秒用力呼气容积(forced expiratory volume in one second,FEV1)、用力肺活量(forced vital capacity,FVC)及FEV1/FVC均升高,且研究组FEV1、FVC及FEV1/FVC高于常规组(P<0.05),两组CCl6、SP-A、SP-D水平均降低,研究组CCl6、SP-A、SP-D低于常规组,有显著性差异(P<0.05);两组不良反应发生率无显著性差异(P<0.05)。结论乙酰半胱氨酸可辅助改善AECOPD患者气道重塑,优化肺功能,降低血清CCl6、SP-A、SP-D水平,疗效显著且安全性高。
Objective To study the effects of acetylcysteine on airway remodeling,lung function and serum pulmonary surfactant protein A(SP-A)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),Lung surfactant protein-D(SP-D)level.Methods Eighty patients with AECOPD admitted to the hospital were random‐ly divided into a conventional group(using conventional symptomatic treatment)and a study group(using acetylcyste‐ine adjuvant therapy on the basis of conventional treatment),with 40 cases in each group.The curative effect was evalu‐ated.The airway remodeling indexes,lung function indexes,and changes in Clara cell protein(CCl6),SP-A,and SP-D levels in the two groups were observed before treatment and 4 weeks after treatment,and adverse reactions were record‐ed.Results The total effective rate of treatment in the study group(85.00%)was higher than that in the conventional group(65.00%),(χ2=4.267,P=0.039);before treatment,the conventional group and the study group had airway remod‐eling related indicators,lung function indicators,CCl6,There was no significant difference in the levels of SP-A and SP-D(P>0.05).After 4 weeks of treatment,the ratio of airway wall thickness to airway lumen outer diameter(T/D)and airway wall area in the study group(WA),WA percentage of total cross-sectional area(WA%)is lower than that of the conventional group,airway cavity area(AI index is higher than that of the conventional group(P<0.05),forced expira‐tory volume per second(FEV1),forced vital capacity of the two groups(FVC)and FEV1/FVC increased,and FEV1,FVC,and FEV1/FVC in the study group were higher than those in the conventional group(P<0.05).The levels of CCl6,SP-A,and SP-D in the two groups decreased.SP-A and SP-D were lower than the conventional group,with significant difference(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Acetylcysteine can help improve airway remodeling in patients with AECOPD,optimize lung function,reduce serum CCl6,SP-A,and SP-D levels,with significant curative effect and high safety.
作者
杨丹
王亮
万宗仁
YANG Dan;WANG Liang;WAN Zongren(Huai'an First Medicine,Nanjing Medical University,Huai an Jiangsu 223300,China)
出处
《中国急救复苏与灾害医学杂志》
2021年第7期774-777,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省卫生厅预防医学科研课题(编号:Y2013016)。
关键词
慢性阻塞性肺疾病
气道重塑
乙酰半胱氨酸
肺功能
血清肺表面活性蛋白
Chronic obstructive pulmonary disease
Airway remodeling
Acetylcysteine
Lung function
Serum pulmo‐nary surfactant protein
