摘要
目的分析应用N-乙酰半胱氨酸(NAC)联合维生素E治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者对其肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、血气水平以及呼吸困难量表评分的影响。方法前瞻性将2018年9月至2019年5月在上海市浦东新区人民医院接受治疗的86例AECOPD患者纳入研究,随机数字表法将其分为2组。对照组43例给予NAC治疗,试验组43例在对照组基础上联合维生素E治疗。2组患者接受生化检验,治疗前和治疗后2周,观察血清炎性因子、血气指标以及抗氧化应激指标状态,通过肺功能检测评估患者肺功能指标,采用呼吸困难量表(MRC)评估患者呼吸困难情况。结果治疗前,2组患者各观察指标比较,差异无统计学意义(P>0.05)。治疗后2周,试验组患者血清IL-6、IL-8、TNF-α水平为(22.36±1.12)ng/L、(0.31±0.07)μg/L、(19.34±1.34)ng/L,均明显低于对照组[(35.91±1.23)ng/L、(0.42±0.13)μg/L、(25.16±1.69)ng/L],差异有统计学意义(P<0.05);治疗后2周,试验组动脉血氧分压(PaO 2)[(69.17±5.02)mmHg]高于对照组[(60.36±5.16)mmHg],动脉血二氧化碳分压(PaCO 2)[(36.49±2.36)mmHg]低于对照组[(40.46±3.74)mmHg],差异有统计学意义(P<0.05);试验组抑制羟自由基能力、抗超氧阴离子自由基能力为(692.47±155.16)、(577.82±173.64)U/mL,高于对照组[(119.62±25.28)、(132.64±26.24)U/mL],谷胱甘肽硫转移酶活力[(21.04±4.13)U/mL]低于对照组[(24.06±4.43)U/mL],第1秒用力呼气量(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1与用力肺活量百分比(FEV1/FVC)肺功能指标为(1.79±0.42)L、(59.47±14.11)%、(61.04±12.31)%,均高于对照组[(1.31±0.48)L、(50.34±14.06)%、(53.64±11.71)%],MRC评分[(2.01±0.26)分]明显低于对照组[(2.76±0.48)分],差异均有统计学意义(P<0.05)。结论NAC联合维生素E应用于AECOPD患者治疗中,能够有效调节炎性因子,改善血气指标,提高肺功能,缓解呼吸困难症状,值�
Objective To analyze the effects of N-acetylcysteine(NAC)and vitamin E on tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),interleukin-8(IL-8),blood gas levels,and the impact of dyspnea scale scores in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Eighty-six patients with AECOPD who were treated in Shanghai Pudong New Area People's Hospital from September 2018 to May 2019 were enrolled in the study and randomly divided into two groups.The control group(43 patients)was received NAC treatment,and the experimental group(43 patients)was based on a combination of vitamin E treatment.The two groups of patients received biochemical tests.Before treatment and 2 weeks after treatment,the status of serum inflammatory factors,blood gas indicators and anti-oxidative stress indicators were observed.The lung function indicators of the patients were evaluated by pulmonary function testing,and the dyspnea scale(MRC)was used for assessment The patient has difficulty breathing.Results Before treatment,there was no significant difference in the observation indexes between the two groups of patients(P>0.05).Two weeks after treatment,the serum levels of IL-6,IL-8 and TNF-αin the experimental group were(22.36±1.12)ng/L,(0.31±0.07)μg/L,(19.34±1.34)ng/L,which were significantly lower than the control group[(35.91±1.23)ng/L,(0.42±0.13)μg/L,(25.16±1.69)ng/L],the differences were statistically significant(P<0.05);the experimental group PaO 2[(69.17±5.02)mmHg]was higher than the control group[(60.36±5.16)mmHg],PaCO 2[(36.49±2.36)mmHg]was lower than the control group[(40.46±3.74)mmHg],the difference was statistically significant(P<0.05);The ability of inhibiting hydroxyl radicals and anti-superoxide anion radicals in the experimental group were(692.47±155.16)and(577.82±173.64)U/mL,which were higher than those of the control group[(119.62±25.28),(132.64±26.24)U/mL],glutathione sulfur transferase activity(21.04±4.13)U/mL was lower than the control group(24.06±4.43)U/mL,FEV1,
作者
樊聪慧
赵庆忠
张黔
宋卫东
万健
FAN Cong-hui;ZHAO Qing-zhong;ZHANG Qian(Department of Emergency and Critical Care Medicine,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China)
出处
《临床和实验医学杂志》
2020年第24期2630-2633,共4页
Journal of Clinical and Experimental Medicine
基金
上海市浦东新区卫生系统领先人才培养计划项目(编号:PWRI2018-08)。
