摘要
目的探讨乙酰半胱氨酸+甲基强的松龙对特发性间质性肺炎(IIP)患者血气指标、肺功能及血清炎症因子的影响。方法选择宜昌市中心人民医院呼吸与危重症医学科收治的80例IIP患者随机分为观察组(42例)、对照组(38例),对照组采用常规对症治疗+甲基强的松龙抗炎,观察组在对照组基础上加用乙酰半胱氨酸片治疗;测定各组治疗前,治疗1周,治疗2周后的临床疗效、血气指标[动脉血氧分压(PaO 2)、动脉血二氧化碳分压(PaCO 2)]、肺功能[用力肺活量(FVC)、一氧化碳弥散量与肺泡通气量比值(DLCO/VA)、第1 s用力呼气容积占预计值百分比(FEV 1%)]、血清转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)、超敏C反应蛋白(hs-CRP)水平与不良反应。结果观察组治疗有效率为85.00%,明显高于对照组65.00%(P<0.05);治疗1周、2周后两组PaO 2均高于治疗前,而PaCO 2低于治疗前,且观察组治疗1周、2周后PaO 2较对照组高,PaCO 2较对照组低(P<0.05);观察组治疗后FVC、DLCO/VA、FEV 1%高于对照组(P<0.05);观察组治疗后血清TGF-β、VEGF、hs-CRP水平明显低于对照组(P<0.01);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论乙酰半胱氨酸片+甲基强的松龙治疗IIP疗效优于单用甲基强的松龙,可明显改善患者血气分析、肺功能,抑制肺纤维化,值得在临床推广实践。
Objective To analyze the effects of acetylcysteine tablets combined with methylprednisolone on blood gas indexes,pulmonary function and serum inflammatory factors in the patients with idiopathic interstitial pneumonia(IIP).Methods A total of 80 patients with IIP who were admitted to the Department of Respiratory and Critical Care Medicine,Yichang Central People′s Hospital,were randomly divided into an observation group(n=42)and a control group(n=38).The control group received routine symptomatic treatment and anti-inflammatory treatment with methylprednisolone.On this basis,the observation group received an additional treatment of acetylcysteine tablets.At two weeks after treatment,the clinical curative effect,the blood gas indexes[the arterial partial pressure of oxygen(PaO 2)and the arterial partial pressure of carbon dioxide(PaCO 2)],the lung functions[the forced vital capacity(FVC),the ratio of diffusing capacity of carbonic oxide and the alveolar volume(DLCO/VA),and the percentage of forced expiratory volume in one second in the predicted value(FEV 1%)],the levels of serum transforming growth factor-β(TGF-β),the vascular endothelial growth factor(VEGF),and the high-sensitivity C-reactive protein(hs-CRP),and the adverse reactions were observed.Results The effective rate of the observation group was significantly higher than that of the control group(85.00%vs.65.00%,P<0.05).The PaO 2 was increased in both groups after 1 week and 2 weeks of treatment,while the PaCO 2 was decreased.The PaO 2 was higher in the observation group than the control group after 1 week and 2 weeks of treatment,while the PaCO 2 was lower in the observation group than the control group(P<0.05).The FVC,DLCO/VA and FEV 1%were higher in the observation group than the control group(P<0.05).After treatment,the levels of serum TGF-β,VEGF and hs-CRP in the observation group were significantly lower than those of the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05
作者
曹路
高宝安
官莉
陈世雄
Cao Lu;Gao Baoan;Guan Li;Chen Shixiong(Department of Respiratory and Critical Care Medicine,Yichang Central People′s Hospital/Institute of Respiratory Diseases,Three Gorges University,Yichang 443000,China)
出处
《中华肺部疾病杂志（电子版）》
CAS
2019年第6期738-742,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
乙酰半胱氨酸片
甲基强的松龙
特发性间质性肺炎
血气分析
肺功能
HRCT
Acetylcysteine tablets
Methylprednisolone
Idiopathic interstitial pneumonia
Blood gas analysis
Pulmonary function
HRCT
