N-乙酰半胱氨酸治疗老年COPD患者的疗效及对免疫功能和祛痰效果的影响  

Therapeutic effects of N acetyl cysteine on COPD in the elderly and its effects on immune function and expectorant effects

作　　者：谢梦莹 XIE Mengying(Emergency Department,The Nineth People＇s Hospital of Wuxi City,Jiangsu,Wuxi 214062,China)

机构地区：[1]江苏省无锡市第九人民医院急诊科,214062

出　　处：《河北医药》2018年第24期3781-3783,3787,共4页Hebei Medical Journal

摘　　要：目的研究N-乙酰半胱氨酸(NAC)治疗老年慢性阻塞性肺疾病(COPD)患者疗效及对免疫功能及祛痰效果的影响。方法选择治疗的老年COPD患者90例,随机均分为观察组和对照组,每组45例。对照组患者给予常规治疗,观察组患者在常规治疗基础上加用NAC治疗。连续治疗3周后比较2组治疗前后肺功能。酶联免疫吸附试验(ELISA)检测血清炎性因子水平,流式细胞仪检测T淋巴细胞亚群水平,并进行痰量评分。结果 2组治疗后肺活量(FVC)、一秒用力呼气量(FEV1)、FEV1%均显著升高,且治疗后组间比较差异有统计学意义(P <0. 05); 2组治疗后血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平均显著降低,且治疗后组间比较差异有统计学意义(P <0. 05); 2组治疗前后各T细胞亚群差异显著,治疗后观察组CD+3、CD+4、CD+4/CD+8、CD+8均与对照组比较差异有统计学意义(P <0. 05); 2组治疗前后痰液评分差异有统计学意义(P <0. 05),治疗后观察组与对照组比较差异有统计学意义(P <0. 05)。结论在常规治疗基础上加用N-乙酰半胱氨酸治疗老年;COPD能显著提升免疫功能及祛痰效果,降低炎性因子水平,提高临床疗效。Objective To investigate the curative effects of N aeeU1 eysteine （NAC） on chronic obstructive pulmonary disease （COPD） in the elderly and the effects of NAC on immune function and expectorant effects. Methods A total of 90 elderly patients with COPD who were treated in our hospital from January 2015 to August 2017 were devided into the observation group （n = 45 ） and control group （n = 45 ）. The patients in control group were treated by conventional therapy, however the patients in observation group, on the basis of conventional therapy, were treated by NAC. After 3-week continuous treatment, the lung function before and after treatment were observed and compared between two groups. The serum levels of inflammatory factors were detected by enzyme linked immunosorbent assay （ELISA） , moreover the levels of T lymphocyte subsets were measured by flow cytometry, and the sputum volume of patients was scored in both groups. Results The forced vital capacity （FVC）, forced expiratory volume （FEV1） and FEV1% after treatment were significantly increased in both groups, as compared with those before treatment （ P 〈 0.05 ） , and there were significantly differences in these indexes after treatment between the two groups （ P 〈 0. 05）. The serum levels of procalcitonin （ PCT）, C reactive protein （ CRP）, interleukin 6 （IL-6） and tumor necrosis factor α （TNF-α） after treatment were significantly decreased in both groups, as compared with those before treatment （ P 〈 0.05 ） , moreover there were significantly differences in the indexes after treatment between the two groups （P 〈 0.05 ）. There were significantly differences in T cell subsets in both groups before and after ＋ treatment , moreover there were significantly differences in CD3^＋ , CD4^＋ , CD4^＋/CD8^＋ , CD8^＋ after treatment between the two groups （ P 〈 0.05 ）. In addition there were significantly differences in sputum scores in both groups before and after treatment, moreover ther

关 键 词：N-乙酰半胱氨酸 老年慢性阻塞性肺疾病 免疫功能 祛痰 

分 类 号：R563[医药卫生—呼吸系统]