维生素C在慢阻肺疾病急性加重患者治疗中的研究  

Research of vitamin C in the treatment of patients with AECOPD

作　　者：陈敏[1] 金志贤[1] 毕虹[1] 杜俊毅[1] 

机构地区：[1]昆明市第一人民医院呼吸2科,云南昆明650011

出　　处：《临床肺科杂志》2016年第3期456-459,共4页Journal of Clinical Pulmonary Medicine

基　　金：昆明市第一人民医院自选项目(No 2011kjc01)

摘　　要：目的探讨维生素C在慢性阻塞性肺疾病(简称:慢阻肺)加重患者治疗中的价值。方法选取60例中、重度慢阻肺急性加重住院患者为研究对象,随机分为治疗组和对照组,对照组给予抗炎、氧疗、平喘等常规治疗,治疗组在常规治疗的基础上给予维生素C口服,测定两组治疗前、治疗10天及20天后血清中丙二醛(malonaldehyde,MDA)、谷胱甘肽(glutathione,GSH)、超氧化物歧化酶(superoxide dismutase,SOD)以及第一秒用力呼气容积占预计值(FEV_1%pre)、呼吸困难评分等。比较两组治疗效果。结果治疗组10天、20天后测定的GSH、SOD及FEV_1%pre较治疗前均有升高、MDA及呼吸困难评分较治疗前均有降低,而20天后测定的GSH及SOD较治疗10天后升高、MDA及呼吸困难评分较治疗10天后降低,差异均有统计学意义(P<0.05),但治疗10天与20天后测定的FEV_1%pre无差异(P>0.05)。对照组治疗前、治疗10天、20天后在MDA、GSH、SOD、FEV_1%pre、呼吸困难评分方面均无统计学差异(P>0.05)。治疗组治疗10天、20天后在相应时间测定的GSH、SOD、FEV_1%pre均高于对照组、MDA及呼吸困难评分均低于对照组,但两组在治疗10天后测定的MDA、FEV_1%pre之间无统计学差异(P>0.05),其余差异均有统计学意义(P<0.05)。治疗组的住院天数(10.77±1.63天)较对照组(13.50±2.06天)缩短,两者之间有统计学差异(P<0.05)。治疗组未发现不良反应。结论维生素C能提高慢阻肺急性加重患者抗氧化能力、减轻氧化应激程度,改善患者肺功能,缩短住院天数。Objective To explore the value of vitamin C in the treatment of patients with AECOPD. Methods 60 moderate-to-severe hospitalized patients with AECOPD were randomly divided into the treatment group and the control group. All patients were given routine therapy including anti-inflammatory, oxygen therapy, anti - asthmatic therapy and so on, and the treatment group was additionally given vitamin C oral therapy. The levels of malonaldehyde （MDA）, glutathione （GSH）, superoxide dismutase （SOD）, FEV1% pre, and dyspnea score were measured before and 10 and 20 days after the treatment between the two groups. Results In the treatment group, the levels of GSH, SOD and FEV1% pre became higher, and the value of MDA and dyspnea score became lower after the treatment, and the difference was more pronounced 20 clays after the treatment than 10 days after the treatment （P 〈 0. 05 ）. But there was no significant difference in FEV1 % pre （ P 〉 0. 05 ）. In the control group, there was no statistical difference in MDA, GSH and SOD, FEV1% pre and dyspnea score before and after the treatment （P 〉 0. 05 ）. The levels of GSH, SOD and FEVl%pre were higher in the treatment group than in the control group 10 and 20 clays after the treatment, and the value of MDA and dyspnea score were lower in the treatment group than in the control group. There was no significant difference in MDA and FEV1% pre 10 clays after the treatment between the two groups （ P 〉 0. 05 ）, but the rest showed statistical significance （P 〈 0. 05 ）. The duration of hospital stay was 10. 77 ± 1.63 days in the treatment group and 13. 50 ± 2. 06 days in the control group （P 〈 0. 05 ）. There was no adverse reactions occurred in the treatment group. Conclusion Vitamin C can increase antioxidative ability, reduce oxidative stress degree, improve pulmonary function, and shorten the duration of hospital stay in the treatment of patients with AECOPD.

关 键 词：维生素C 慢性阻塞性肺疾病急性加重 治疗 

分 类 号：R563.9[医药卫生—呼吸系统]