阿奇霉素联合N-乙酰半胱氨酸对老年稳定期慢性阻塞性肺疾病的疗效  

Therapeutic efficacy of different-course azithromycin combined with NAC in elderly patients with COPD at stable stage

作　　者：吴映南 崔文佳 薛明月 Wu Ying-nan;Cui Wen-jia;Xue Ming-yue(Department of Respiratory Medicine,Hai’an People’s Hospital,Hai’an 226600,China)

机构地区：[1]海安市人民医院呼吸内科,海安226600

出　　处：《中国药物应用与监测》2024年第1期13-16,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探讨N-乙酰半胱氨酸(NAC)结合不同疗程阿奇霉素治疗老年稳定期慢性阻塞性肺疾病(COPD)的疗效。方法选择2020年3月—2023年3月期间我院治疗的COPD稳定期老年病人共114例为研究对象,按随机数字表法分为A、B、C组各38例。所有患者均接受阿奇霉素联合NAC治疗,A、B、C组分别连续用药3、6、12个月。比较三组治疗前后肺功能、临床疗效、6 min步行距离(6MWT)、急性呼吸加重次数、血清炎症因子以及不良反应率。结果B组92.11%和C组94.74%总有效率均高于A组65.79%(P<0.05),而B、C两组之间差异无统计学意义(P>0.05);治疗后三组患者急性加重次数、血清中白细胞介素(IL)-6、IL-8和肿瘤坏死因子-α(TNF-α)水平较治疗前均下降。用力肺活量(FVC)、第1秒的用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量百分率(FEV1/FVC)具体水平和6MWT均增加。B、C组患者的急性呼吸加重次数、IL-6、IL-8和TNF-α水平均低于A组(均P<0.05),FEV1、FVC、FEV1/FVC水平和6MWT均高于A组(均P<0.05)。治疗后B、C两组上述指标比较无明显差异(P>0.05);治疗期间三组不良反应率差异无统计学意义(均P>0.05)。结论NAC结合阿奇霉素三种不同的用药疗程对于COPD稳定期老年病人炎症因子具体浓度水平及肺功能改善效果较好,但用药6、12个月效果更佳。Objective To explore the clinical efficacy of different-course azithromycin combined with N-acetylcysteine(NAC)on elderly patients with COPD at stable stage.Methods A total of 114 elderly patients with COPD at stable stage admitted to our hospital from March 2020 to March 2023 were enrolled for this stud and randomly divided into 3 groups with 36 in each.The patients in group A,B and C were treated with azithromycin combined with NAC for 3,6 and 12 consecutive months,respectively.Then pulmonary function,clinical outcome,6-minute walk test(6-MWT),number of acute exacerbations,serum inflammatory factors and adverse effect rates were compared among the 3 groups.Results The overall efficacy rate was 92.11%in group B and 94.74%in group C,which was higher than that of 65.79%in group A(P<0.05),and no statistical difference was found between group B and C(P>0.05).A reduction in number of acute exacerbations,serum levels of interleukin(IL)-6,IL-8 and tumour necrosis factor-alpha(TNF-α),and an increase in inforced vital capacity(FVC),forced expiratory volume in first second(FEV1),FEV1/FVC,and 6MWT were observed in all patients after treatment(P<0.05),and both improvements were more notable in group B and C as compared to group A(P<0.05),whereas the above parameters yielded no statistical difference between group B and C(P>0.05).The rate of adverse reactions during treatment yielded no statistical difference among the 3 groups(P>0.05).Conclusion All three courses of azithromycin combined with NAC can effectively improve the lung function and inflammation response in elderly patients with COPD at stable stage.But the effect is better after medication for 6 and 12 months.

关 键 词：慢性阻塞性肺疾病 老年稳定期 阿奇霉素 N-乙酰半胱氨酸 不同用药疗程 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]