吸入用乙酰半胱氨酸溶液雾化吸入治疗老年慢性阻塞性肺疾病急性加重期的疗效观察  

Efficacy observation of acetylcysteine solution for inhalation in treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：刘爱文 王学亮[1] LIU Ai-wen;WANG Xue-liang(The Fifth People's Hospital of Jinan Affiliated to Weifang Medical Uuniversity,Jinan 250022,China)

机构地区：[1]潍坊医学院附属济南市第五人民医院呼吸内科,250022

出　　处：《中国实用医药》2023年第18期100-103,共4页China Practical Medicine

摘　　要：目的探讨吸入用乙酰半胱氨酸溶液雾化吸入治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法74例老年AECOPD患者作为研究对象,随机分为对照组和观察组,每组37例。两组患者均给予常规治疗,观察组在常规治疗基础上给予吸入用乙酰半胱氨酸溶液雾化吸入治疗,对照组在常规治疗基础上给予0.9%氯化钠溶液(NaCl)雾化吸入治疗。比较两组患者治疗前后的动脉血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清C反应蛋白(CRP)、血清前白蛋白(PA)及肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)],治疗后FEV1测量的差值(△FEV1)、△FVC测量的差值(△FVC)及△FVC/△FEV1。结果治疗后,两组患者PaO_(2)均明显高于本组治疗前,PaCO_(2)均明显低于本组治疗前,且观察组患者PaO_(2)(83.8±8.4)mm Hg(1 mm Hg=0.133 kPa)明显高于对照组的(77.5±7.5)mm Hg,PaCO_(2)(45.3±7.4)mm Hg明显低于对照组的(51.6±6.9)mm Hg,差异有统计学意义(P<0.05)。治疗后,两组患者CRP明显低于本组治疗前,PA明显高于本组治疗前,且观察组患者CRP(23.40±9.51)mg/L低于对照组的(32.27±10.23)mg/L,PA(301.43±33.18)mg/L高于对照组的(266.37±30.52)mg/L,差异有统计学意义(P<0.05)。治疗前后,两组患者组内及组间FEV1比较,差异无统计学意义(P>0.05);治疗后,两组患者FVC均明显高于本组治疗前,且观察组患者FVC(2.54±0.34)L高于对照组的(2.33±0.31)L,差异有统计学意义(P<0.05)。治疗后,观察组患者△FVC(370.00±91.63)ml、△FVC/△FEV1(4.63±1.66)明显高于对照组的(210.00±74.58)ml、(2.33±1.17),差异有统计学意义(P<0.05);两组患者△FEV1比较差异无统计学意义(P>0.05)。结论吸入用乙酰半胱氨酸溶液能明显改善老年AECOPD患者的机体炎症反应和小气道陷闭状态,缓解临床症状,提高疗效。Objective To discuss the clinical efficacy of acetylcysteine solution for inhalation in treatment of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 74 elderly patients with AECOPD were randomly divided into control group and observation group,with 37 cases in each group.Patients in both groups were given conventional treatment.In addition,the observation group was treated with acetylcysteine solution for inhalation,while the control group was treated with atomized inhalation of 0.9%sodium chloride solution(NaCl).Both groups were compared in terms of arterial blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],serum C-reactive protein(CRP),serum prealbumin(PA)and lung function indicators[forced expiratory volume in one second(FEV1)and forced vital capacity(FVC)]before and after treatment,the difference in FEV1measurements before and after treatment(△FEV1),the difference in FVC measurements before and after treatment(△FVC),and△FVC/△FEV1 after treatment.Results After treatment,PaO_(2)in both groups was significantly higher than that before treatment in this group,and PaCO_(2)was significantly lower than that before treatment in this group;PaO_(2)of(83.8±8.4)mm Hg(1 mm Hg=0.133 kPa)in the observation group was significantly higher than that of(77.5±7.5)mm Hg in the control group;PaCO_(2)(45.3±7.4)mm Hg in the observation group was significantly lower than that of(51.6±6.9)mm Hg in the control group;the differences were statistically significant(P<0.05).After treatment,CRP in both groups was significantly lower than that before treatment in this group,and PA was significantly higher than that before treatment in this group;CRP of(23.40±9.51)mg/L in the observation group was lower than that of(32.27±10.23)mg/L in the control group;PA of(301.43±33.18)mg/L in the observation group was higher than that of(266.37±30.52)mg/L in the control group;the differences were statistically si

关 键 词：吸入用乙酰半胱氨酸溶液 慢性阻塞性肺疾病急性加重期 血气分析 肺功能 C反应蛋白 前白蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]