洪克付;王士国;邓爱华;
HONG Kefu;WANG Shiguo;DENG Aihua;Department of Respiratory,People's Hospital of Yicheng City;

• 1:宜城市人民医院呼吸内科

摘要(Abstract)：

目的:观察乙酰半胱氨酸片辅助治疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者治疗效果和作用机制。方法:96例AECOPD患者,随机分为对照组(n=46)和观察组(n=50),对照组给予COPD常规治疗,观察组在常规治疗基础上辅以乙酰半胱氨酸片治疗,比较两组治疗前后血清丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)含量及超氧化物歧化酶(SOD)表达水平,同时比较两组AECOPD患者治疗前后残气容积(RV)/肺总量(TLC)、1秒用力肺活量(forced expiratory volume,FEV1)变化。结果:与治疗前比较,治疗后两组AECOPD患者MDA、RV/TLC明显降低(P<0.05),GSH-PX、SOD表达水平以及FEV1明显升高(P<0.05),且观察组各项指标改善幅度明显优于对照组(P<0.05)。结论:乙酰半胱氨酸片通过抑制氧自由基,提高GSH-PX、SOD表达等调节氧化应激反应,从而改善AECOPD患者肺功能。
Objective: To investigate the curative effects of fluimucil in treating acute exacerbation of chronic obstructive pulmonary disease( AECOPD) and its mechanism. Methods: A total of 96 AECOPD patients were randomly divided into control group( n = 46) and observation group( n = 50),the patients in control group were given routine COPD therapy,on the basis of treatment in control group,patients in observation group were treated with fluimucil,the levels of malondialdehyde( MDA),glutathione peroxidase( GSH-PX) and superoxide dismutase( SOD) were detected before and after treatment. Residual volume( RV)/total lung capacity( TLC) and forced expiratory volume in 1 second( FEV1) were compared in the two groups before and after treatment. Results: MDA levels and RV/TLC of the two groups were decreased significantly after treatment( P < 0. 05),GSH-PX,SOD levles and FEV1 were increased significantly after treatment( P < 0. 05); and the improvement of the indexes in observation group was more obvious than that control group( P < 0. 05). Conclusion: Fluimucil can inhibit oxygen free radicals,increase GSH-PX and SOD expression levels and regulate of oxidative stress reaction,thus improve lung function in patients with AECOPD.

关键词(KeyWords)： 乙酰半胱氨酸片;氧化应激;慢性阻塞性肺疾病加重期;肺功能;丙二醛;超氧化物歧化酶;谷胱甘肽过氧化物酶
acetylecysteine tablets;oxidative stress;acute exacerbation of chronic obstructive pulmonary disease;pulmonary function;malondialdehyde;superoxide dismutase;glutathione peroxidase

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 洪克付;王士国;邓爱华;
HONG Kefu;WANG Shiguo;DENG Aihua;Department of Respiratory,People's Hospital of Yicheng City;

DOI: 10.19367/j.cnki.1000-2707.2015.03.027

参考文献(References)：

• [1]夏敬文,董樑,龚益,等.连花清瘟(LHQW)胶囊对慢性阻塞性肺疾病急性加重期(AECOPD)患者诱导痰炎性因子的影响[J].复旦学报:医学版,2014(2):243-247.
• [2]崔正森,李菡,姜宝珍,等.慢性阻塞性肺疾病、肺炎和肺癌患者血清HMGB1水平及临床意义[J].安徽医科大学学报,2014(6):812-815.
• [3]戚春辉,施国华,汪永锋,等.D-二聚体、血液流变学检测在慢性阻塞性肺疾病急性加重期患者中的临床意义[J].中国实验诊断学,2014(5):806-807.
• [4]周琦,李爱华.全身激素治疗对慢性阻塞性肺疾病急性加重期患者糖代谢的影响[J].山东医药,2014(21):42-44.
• [5]张连东,裴新军,谭美春,等.慢性阻塞性肺疾病急性加重期血清瘦素与肺功能关系的临床研究[J].中国急救医学,2014(8):708-710.
• [6]王卫,陈燕明.N-乙酰半胱氨酸联合沙美特罗氟替卡松治疗慢性阻塞性肺疾病临床疗效[J].国际呼吸杂志,2013(11):813-818.
• [7]郝月琴,张春.富露施对慢性阻塞性肺疾病患者急性加重期疗效及氧化/抗氧化失衡的影响[J].中国现代医学杂志,2007(9):1123-1125.
• [8]买尼沙本·亚生.乙酰半胱氨酸辅助治疗慢性阻塞性肺疾病急性加重期患者的疗效及其对氧化应激、肺功能的影响[J].实用临床医药杂志,2014(17):47-51.
• [9]刘婷婷,康焰,许照敏,等.高频胸壁震荡在慢性阻塞性肺疾病急性加重期有创通气患者治疗中的作用[J].中华结核和呼吸杂志,2014(4):255-259.
• [10]高静珍,陈宝元.盐酸氨溴索不同持续使用时间对慢性阻塞性肺疾病急性加重期的治疗效果[J].中华老年医学杂志,2014(3):294-296.
• [11]杨雪梅,叶艳.N-乙酰半胱氨酸联合沙美特罗/氟替卡松对慢性阻塞性肺疾病急性加重的疗效分析[J].实用医学杂志,2013(22):3751-3753.
• [12]鞠善良,李超,王在义,等.N-乙酰半胱氨酸联合小剂量糖皮质激素治疗特发性肺间质纤维化疗效的Meta分析[J].中国循证医学杂志,2013(6):717-722.

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