乙酰半胱氨酸泡腾片联合倍氯米松对COPD患者免疫功能及ESR、PCT水平的影响  

Effect of acetylcysteine effervescent tablets combined with beclomethasone suspension on immune function,erythrocyte sedimentation rate,and procalcitonin levels in patients with chronic obstructive pulmonary disease

作　　者：贝震 吴俊沛 Bei Zhen;Wu Junpei(Department of Respiratory Medicine,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]义乌市中心医院呼吸内科,义乌322000

出　　处：《中国基层医药》2024年第7期982-987,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨乙酰半胱氨酸泡腾片联合倍氯米松混悬液对慢性阻塞性肺疾病(COPD)患者免疫功能及红细胞沉降率(ESR)、降钙素原(PCT)水平的影响。方法回顾性分析2022年1月至2023年6月义乌市中心医院收治的COPD患者102例的临床资料,根据治疗方法的不同将其分为A组(n=51)、B组(n=51)。A组:对症治疗+倍氯米松混悬液,B组:A组+乙酰半胱氨酸泡腾片。比较两组患者的临床疗效、运动耐力、临床症状、生活质量、免疫功能、血清_(ESR)、_(PCT)水平。结果B组总有效率为96.08%(49/51),明显高于A组的82.35%(42/51)(χ^(2)=5.14,P<0.05)。A组治疗后的6 min步行试验(6MWT)、CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)[(317.19±46.70)m、(54.53±7.98)%、(34.76±4.23)%、(1.20±0.28)]均明显长于、高于治疗前[(266.49±43.01)m、(49.38±8.27)%、(28.75±3.33)%、(0.85±0.21)](t6WMT=5.70、tCD_(3)^(+)=3.20,tCD_(4)^(+)=7.97,tCD_(4)^(+)/CD_(8)^(+)=7.14,均P<0.001)。B组治疗后的6MWT、CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)[(328.19±41.48)m、(60.02±5.17)%、(36.89±5.59)%、(1.37±0.27)]均明显长于、高于治疗前[(265.69±49.60)m]、(44.33±7.34)%、(28.59±4.35)%、(0.83±0.12)](t6WMT=6.90、tCD_(3)^(+)=12.48,tCD_(4)^(+)=8.36,tCD_(4)^(+)/CD_(8)^(+)=13.05,均P<0.001);且B组治疗后6MWT、CD_(3)^(+)、CD_(4)^(+)及CD_(4)^(+)/CD_(8)^(+)均长于、高于A组(t6WMT=3.35,tCD_(3)^(+)=10.94,tCD_(4)^(+)=5.83,tCD_(4)^(+)/CD_(8)^(+)=8.42,均P<0.05)。A组患者治疗后的改良版英国医学研究会呼吸问卷(_(mMRC))、COPD评估测试(_(CAT))评分、CD_(8)^(+)、_(ESR)、_(PCT)[(1.30±1.04)分、(14.37±4.58)分、(30.61±8.32)%、(24.28±4.88)mm/h、(0.44±0.16)μg/L]均明显低于治疗前[(2.53±0.85)分、(20.10±6.34)分、(35.90±9.71)%、(33.26±6.28)mm/h、(0.72±0.16)μg/L](t_(mMRC)=6.54、t_(CAT)=5.23、t_(CD8^(+))=4.21、t_(ESR)=8.06、t_(PCT)=8.83,均P<0.05)。B组患者治疗后的_(mMRC)、_(CAT)评分、CD_(8)^(+)、_(ESR)、_(PCT)[(1.09±0.90)分、(13.58�Objective To investigate the effect of acetylcysteine effervescent tablets combined with beclomethasone suspension on immune function,erythrocyte sedimentation rate (ESR),and procalcitonin (PCT) levels in patients with chronic obstructive pulmonary disease(COPD).Methods The clinical data of 102 patients with COPD admitted to Yiwu Central Hospital from January 2022 to June 2023 were retrospectively analyzed.These patients were divided into Group A(n=51)and Group B(n=51)based on different treatment methods.Group A received symptomatic treatments and beclomethasone suspension,while Group B received the same treatment as Group A plus acetylcysteine effervescent tablets.The clinical efficacy,exercise tolerance,clinical symptoms,quality of life,immune function,and serum ESR and PCT levels were compared between Groups A and B.Results The total response rate in Group B was 96.08%(49/51),which was significantly higher than that in Group A[82.35%(42/51),χ^(2)=5.14,P<0.05].After treatment,Group A showed significantly longer distance in the 6-minute walk test(6MWT)and higher levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)ratio[(317.19±46.70)m,(54.53±7.98)%,(34.76±4.23)%,(1.20±0.28)]compared with before treatment[(266.49±43.01)m,(49.38±8.27)%,(28.75±3.33)%,(0.85±0.21)](t6MWT=5.70,tCD_(3)^(+)=3.20,tCD_(4)^(+)=7.97,tCD_(4)^(+)/CD_(8)^(+)=7.14,all P<0.001).Group B exhibited significantly longer distance in the 6MWT as well as higher levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)ratio after treatment[(328.19±41.48)m,(60.02±5.17)%,(36.89±5.59)%,(1.37±0.27)]compared with before treatment[(265.69±49.60)m,(44.33±7.34)%,(28.59±4.35)%,(0.83±0.12)](t6MWT=6.90,tCD_(3)^(+)=12.48,tCD_(4)^(+)=8.36,tCD_(4)^(+)/CD_(8)^(+)=13.05,all P<0.001).After treatment,the distance in 6MWT and the levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+)in Group B were significantly longer or higher compared with Group A(t6MWT=3.35,tCD_(3)^(+)=10.94,tCD_(4)^(+)=5.83,tCD_(4)^(+)/CD_(8)^(+)=8.42,all P<0.05).After treatm

关 键 词：肺疾病 慢性阻塞性 血沉 CD4阳性T淋巴细胞 CD8阳性T淋巴细胞 乙酰半胱氨酸 倍氯米松 治疗结果 

分 类 号：R563.9[医药卫生—呼吸系统]