乙酰半胱氨酸片联合BiPAP呼吸机治疗慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停综合征(重叠综合征)的临床疗效观察  

The clinical efficacy of acetylcysteine antioxidant combined with BiPAP respirator in treatment of Overlap Syndrome

作　　者：叶胜兰[1,2] 李承红[1,2] 

机构地区：[1]江汉大学附属医院 [2]武汉市六医院呼吸科,湖北武汉430015

出　　处：《中国医院药学杂志》2011年第16期1362-1365,共4页Chinese Journal of Hospital Pharmacy

基　　金：武汉市卫生局临床医学科研项目(编号:武卫[2010]42号)

摘　　要：目的:研究探讨乙酰半胱氨酸片抗氧化联合BiPAP呼吸机治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSAS)重叠综合征(COPD-OSAS)的临床治疗效果。方法:平行开放的方法选取某院2008-2010年COPD-OSAS重叠综合征160例,随机分为乙酰半胱氨酸片联合BiPAP呼吸机组(A组)40例、单用乙酰半胱氨酸片组(B组)40例、单用BiPAP呼吸机组(C组)40例和常规治疗组(D组)40例;观察记录入院时及治疗2周结束时患者的临床症状、氧化/抗氧化指标(SOD)、内皮素(ET-1)、多导睡眠检测PSG(SEF、TDB、SLT90%)和肺功能(FEV1%、FEV1/FVC)等方面有无差异。结果:(1)4组治疗前、后SOD、ET-1差异有显著性(P<0.05);且各组治疗后SOD、ET-1差异有显著性(P<0.05);其中A组SOD、ET-1下降幅度明显高于B组和C组。(2)4组治疗前、后多导睡眠监测、肺功能资料差异有显著性(P<0.05);而且各组治疗后多导睡眠监测、肺功能资料差异有显著性(P<0.05);其中A组SEF、FEV1%和FEV1/FVC上升幅度明显高于B组和C组,而A组TDB、SLT90%下降幅度明显高于B组和C组。结论:乙酰半胱氨酸片抗氧化联合BiPAP呼吸机治疗重叠综合征有较好的临床疗效,在呼吸科领域具有广泛的应用前景,值得临床推广。OBJECTIVE To evaluate the clinical efficacy of acetylcysteine antioxidant combined with BiPAP respirator in treatment of Overlap Syndrome（Chronic obstructive pulmonary disease combined with obstructive sleep apnea hypopnea syndrome,OS）.METHODS 160 patients with OS were divided into four groups randomly： acetylcysteine antioxidant combined with BiPAP respirator group（group A）,only acetylcysteine antioxidant group（group B）,only BiPAP respirator group（group C）and routine therapy group（group D）;The clinical symptom score,polysomnography PSG（SEF,TDB,SLT90%）,arterial blood gas analysis（pH,PaO2,PaCO2,SaO2）,pulmonary function（FEV1,FEV1%,FEV1/FVC and MVV%）,etc were recorded before and after therapy in every groups.RESULTS（1） In the former four groups there were significantly differences before,etc and after therapy（P0.05）.Further more,after therapy,there were also significantly different between the former four groups.The decrease in levels of SOD and ET-1 was higher in group A patients than those in the group B and group C;（2）The same trends（P0.05）happened in the record of arterial blood gas analysis,pulmonary function.The increase in levels of SEF,FEV1% and FEV1/FVC was higher in group A patients than those in the group B and group C.The decrease in levels of TDB and SLT 90% bay higher in group A patients than those in the group B and group C.CONCLUSION Acetylcysteine antioxidant combined with BiPAP respirator had a good effect in Overlap Syndrome patients.

关 键 词：乙酰半胱氨酸片 抗氧化 BIPAP呼吸机 重叠综合征 多导睡眠监测 

分 类 号：R969[医药卫生—药理学]