哮喘-慢性阻塞性肺疾病重叠综合征患者氧化应激水平及抗氧化治疗效果的研究  

Oxidative Stress and Antioxidant Therapy in Patients with Asthmatic Chronic Obstructive Pulmonary Disease Overlap Syndrome

作　　者：刘凌云[1] 曾勉[2] 左万里[1] 康丽玫[1] 

机构地区：[1]广东省江门市中心医院,广东江门529000 [2]中山大学第一附属医院

出　　处：《中国医学创新》2016年第21期9-13,共5页Medical Innovation of China

摘　　要：目的:本研究旨在探讨哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者全身氧化应激水平及抗氧化治疗效果。方法:选择2012年6月-2014年6月本院诊治的稳定期ACOS患者60例(ACOS组),同期在本院体检中心体检的健康吸烟者60例(对照组);ACOS组按随机数字表法分为常规治疗组和抗氧化治疗组。常规治疗组接受单纯吸入糖皮质激素/长效β2受体激动剂(沙美特罗/氟替卡松粉吸入剂50/500μg,早晚各1次吸入)治疗,抗氧化治疗组在常规治疗基础上加用N-乙酰半胱氨酸600 mg,2次/d,疗程3个月。所有测试者治疗前后进行肺通气功能检查、支气管舒张试验、动脉血气分析,并测定血清MDA、GSH含量、SOD活性。结果:ACOS组患者血清MDA较对照组明显升高,而血清GSH含量和SOD活性均较对照组明显下降(P<0.05);ACOS组患者血清MDA与FEV1显著负相关(r=-0.745,P<0.05),而血清GSH含量、SOD活性与FEV1呈显著正相关(r=0.779,P<0.05;r=0.698,P<0.05);常规治疗组和抗氧化治疗组治疗前后血清MDA下降,而血清GSH含量、SOD活性及FEV1上升(P<0.05);抗氧化治疗组血清MDA、血清GSH含量、SOD活性及FEV1变化幅度较常规治疗组明显(P<0.05)。结论:ACOS患者体内存在全身性的氧化/抗氧化失衡,且与其肺功能下降有关。N-乙酰半胱氨酸抗氧化治疗能改善ACOS患者体内全身性氧化/抗氧化失衡,从而改善其肺功能。Objective：To investigate the oxidative stress and curative effects of fluimucil in treating Asthma-COPD overlap syndrome（ACOS）.Method：A total of 60 patients with stable ACOS from June 2012 to June 2014 in our hospital patients（ACOS group） and 60 healthy smokers in the same period in our hospital physical examination center（the control group） were selected.ACOS group was randomly divided into routine treatment group and antioxidant treatment group.Routine treatment group received simple inhalation of Glucocorticoid/Long-actingβ2 Receptor Agonist（Salmeterol/Fluorine Fluticasone Propionate Powder for Inhalation 50/500μg, two times a day）,while antioxidant treatment group added the N acetylcysteine 600 mg twice/day based on routine treatment group.The course of treatment was 3 months.Pulmonary function tests,bronchial dilation test,arterial blood gas analysis,and serum MDA,GSH content,SOD activity were performed before and after treatment in all testers.Result：Compared with the control group,serum MDA,and GSH content in serum of ACOS group were significantly higher,the activity of superoxide dismutase（SOD） of ACOS group compared with the control group was decreased significantly（P〈0.05）.ACOS group serum MDA and FEV1 significantly negative correlation（P〈0.05）,and GSH content in serum,SOD activity and FEV1 significantly positive correlation（P〈0.05）.Routine treatment group and Antioxidant treatment group before and after treatment,serum MDA decreased,and GSH content in serum,SOD activity and FEV1 rose（P〈0.05）.Antioxidant treatment group,the serum levels of MDA decreased and GSH content in serum,SOD activity and FEV1 increased amplitude compared with routine treatment group significantly（P〈0.05）.Conclusion：ACOS patients have systemic oxidation/antioxidant imbalance,and the imbalance are related to the decline in lung function.N-acetyl cysteine oxidation treatment can improve ACOS patients systemic oxidation/antioxidant imbalance,so as to improve their lung funct

关 键 词：哮喘-慢性阻塞性肺疾病重叠综合征 氧化应激 乙酰半胱氨酸片 肺功能 丙二醛 超氧化物歧化酶 还原型谷胱甘肽 

分 类 号：R563.9[医药卫生—呼吸系统]