摘要
目的观察噻托溴铵联合N-乙酰半胱氨酸(NAC)治疗慢性阻塞性肺疾病(COPD)的临床疗效。方法采用简单随机数表法将2015年1月至2016年1月在成都医学院第一附属医院呼吸内科住院治疗后病情稳定的128例COPD患者分为观察组与对照组,每组64例,对照组在常规治疗基础上单用噻托溴铵粉雾剂吸入治疗(18μg/次,1次/d),观察组在对照组治疗的基础上加用NAC泡腾片口服(600 mg/次,1次/d),疗程均为4个月。比较两组患者治疗前后的呼吸困难(m MRC)分级、动脉血气指标和肺功能指标。结果与治疗前比较,治疗后观察组和对照组m MRC分级均降低,且观察组较对照组m MRC分级下降更显著,差异均有统计学意义(P<0.05);治疗后,观察组和对照组动脉血氧分压(Pa O2)和血氧饱和度(Sa O2)均高于本组治疗前[(85.64±7.90)mm Hg vs(59.77±10.85)mm Hg、(77.56±6.52)mm Hg vs(58.61±8.70)mm Hg和(95.13±2.61)%vs(86.64±5.76)%、(93.92±2.41)%vs(85.44±4.84)%],且观察组Pa O2和Sa O2较对照组升高更明显,差异均有统计学意义(P<0.05);治疗后,观察组和对照组动脉血二氧化碳分压(Pa CO2)均低于本组治疗前[(42.58±5.53)mm Hg vs(61.13±10.62)mm Hg和(46.84±6.06)mm Hg vs(58.61±8.70)mm Hg],且观察组Pa CO2较对照组下降更明显,差异均有统计学意义(P<0.05);治疗后,观察组和对照组第1秒用力呼气容积(FEV1)均高于本组治疗前[(1.78±0.51)L vs(1.36±0.58)L和(1.60±0.52)L vs(1.40±0.51)L],且观察组较对照组升高更明显,差异均有统计学意义(P<0.05);治疗后,观察组和对照组用力肺活量(FVC)和FEV1占预计值百分比(FEV1%pred)均较本组治疗前升高[(2.81±0.71)L vs(2.42±0.73)L、(2.52±0.74)L vs(2.36±0.73)L和(61.14±17.51)%vs(46.05±17.56)%、(51.70±18.60)%vs(45.48±17.78)%],且观察组较对照组升高更明显,差异均有统计学意义(P<0.05),但对照组治疗前后差异均无统计学意义(P>0.05)。结论与单用噻托溴铵相比,噻托溴铵联合NAC对COPD稳定
Objective To investigate the therapeutic effect of tiotropium bromide combined with N-acetylcysteine（NAC） therapy for patients with stable chronic obstructive pulmonary disease（COPD）. Methods A total of 128 stable COPD patients after hospitalization in the First Affiliated Hospital of Chengdu Medical College from January 2015 to January 2016 were selected and randomly divided into observation group and control group by simple random number table method, with 64 patients in each group. The control group was given conventional therapy and inhalation treatment of tiotropium bromide（18 μg/time, qd）, while the observation group was given conventional therapy and inhalation treatment of tiotropium bromide（18 μ g/time, qd） combined with NAC effervescent tables orally（600 mg/time, qd）. The course of treatment was 4 months. Modified British Medical Research Council（m MRC） grades, arterial blood gas index and pulmonary function index before and after treatment in both groups were compared. Results After treatment, the patients in both observation and control groups had significant lower m MRC grades than those before treatment（P〈0.05）, and the patients in observation group had significant lower m MRC grades than those in control group（P〈0.05）.The patients in both observation and control groups had significant higher arterial partial pressure of oxygen（Pa O2） and arterial blood oxygen saturate（Sa O2） after treatment compared with before treatment：（85.64 ± 7.90） mm Hg vs（59.77 ±10.85） mm Hg,（77.56 ± 6.52） mm Hg vs（58.61 ± 8.70） mm Hg and（95.13 ± 2.61）% vs（86.64 ± 5.76）%,（93.92 ± 2.41）% vs（85.44 ± 4.84）%, respectively, P0.05, and the patients in observation group had significant higher Pa O2 and Sa O2 than those in control group（P〈0.05）. The patients in both observation and control groups had significant lower arterial partial pressure of carbon dioxide（Pa CO2） after treatment compared with before treatment：（42.58 ± 5.53）
作者
马春兰
王春茂
李万成
李艳芳
MA Chun-lan;WANG Chun-mao;LI Wan-cheng;LI Yan-fang(Department of Respiratory Medicine 1, Department of Infection;the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan, CHINA)
出处
《海南医学》
CAS
2018年第8期1072-1075,共4页
Hainan Medical Journal
关键词
噻托溴铵
N-乙酰半胱氨酸
慢性阻塞性肺疾病
呼吸困难
肺功能
Tiotropium bromide
N-acetylcysteine
Chronic obstructive pulmonary disease
Dyspnea
Pulmonary function
