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  

Clinical efficacy of combined N-acetylcysteine with Salmeterol/Fluticasone in the treatment of chronic obstructive pulmonary diseases

作　　者：王卫[1] 陈燕明[1] 

机构地区：[1]南京医科大学附属苏州医院呼吸内科,苏州215008

出　　处：《国际呼吸杂志》2013年第11期813-818,共6页International Journal of Respiration

摘　　要：目的探讨N乙酰半胱氨酸（富露施）联合沙美特罗氟替卡松（舒利迭，50／500“g）治疗慢性阻塞性肺疾病（COPD）的临床疗效。方法选择60例稳定期COPD患者，随机分为治疗组与对照组各30例，治疗组给予N-乙酰半胱氨酸联合沙美特罗氟替卡松，对照组单纯给予沙美特罗氟替卡松。在治疗后3个月、6个月、12个月后比较治疗组与对照组的第1秒用力呼气容积占预计值百分比（FEV1％pred）、最大呼气流速（PEF）、6分钟步行距离（6MWD）、COPD评估测试（CAT）及COPD急性加重（AECOPD）次数。结果FEV，％pred、PEF、6MWD均呈上升趋势，CAT呈下降趋势。经重复测量设计的方差分析，实验组与对照组的FEV。％pred、PEF在组间、不同测量时间、组别＊测量时间之间的差异具有统计学意义（P=0．000）；经多重分析显示，实验组（FEV1％pred、PEF）在以3个月、6个月、12个月为结点均高于对照组（P〈0．05），两组治疗后不同时间结点均高于治疗前。6MWD、CAT仅在不同测量时间、组别＊测量时间的差异具有统计学意义（P=0．000）；经多重分析显示，两组治疗后6MWD在不同时间结点均高于治疗前，但CAT在不同时间结点与治疗前相比均有下降。AECOPD次数仅在持续治疗12个月后实验组和对照组的差异具有统计学意义（χ2=4．44，P=0．035）。结论N-乙酰半胱氨酸联合沙美特罗氟替卡松能改善COPD患者的肺功能和生活质量，同时对增加运动耐量和减少COPD发作频率有显著疗效。Objective The study aims to investigate the clinical efficacy of combined N-acetylcysteine （Fluimucil） with Salmeterol/Fluticasone （Seretide, 50/500 μg） in the treatment of chronic obstructive pulmonary disease （COPD）. Methods Sixty cases of patients with stable COPD were selected and randomly divided into two equal sized groups, i.e. the treatment group and the control group. The patients in the treatment group were treated with a combined medication of N-acetylcysteine and Salmeterol/Flutieasone, while those in the control group only received Salmeterol/Flutieasone. At 3, 6 and 12 months after medication, the values of FEV, Gpred, PEF,6MWD, CAT and AECOPD were compared between the two groups. Results The values of FEVI %pred, PEF and 6MWD all depicted an ascending trend while that of CAT showed a descending one. From repeated-measures ANOVA on the pulmonary functions （FEV1 Gpred and PEF） in both groups, the differences between the two groups at each time intervals, the differences among the various time intervals and the group ~ time interactions were significant （ P =0. 000）. The results of multiple analysis showed that the values obtained （FEV1% pred and PEF） from the treatment group at 3,6 and 12 months were all higher than those from the control group correspondingly （ P 〈0.05）, and the values obtained from both groups at each of the time intervals post medication were all higher than those pre-treatment. For 6MWD and CAT, only the differences among the various time intervals and the group ＊ time interactions were significant （ P = 0. 000）. The results of multiple analysis showed that 6MWD values obtained from the two groups at each time intervals all increased while CAT values at each time intervals all declined when compared with the pre-treatment findings. For the frequency of AECOPD, only the intergroup difference after implementing the treatments for consecutive 12 months were significant （χ2= 4.44, P = 0. 035）. Conclusions Besides improving the pulmonary funct

关 键 词：慢性阻塞性肺疾病 N-乙酰半胱氨酸 沙美特罗氟替卡松 第1秒用力呼气容积占预计值百分比 最大呼气流速 

分 类 号：R563.9[医药卫生—呼吸系统]