N-乙酰半胱氨酸联合Bi-PAP治疗老年COPD合并呼吸衰竭患者的疗效及对患者免疫功能的影响  

Efficacy and Immune Function of N-acetylcysteine Combined with Bi-PAP in Elderly COPD Patients with Respiratory Failure

作　　者：李彦斌 杨梦鸿 王粉利 武卫东 LI Yanbin;YANG Menghong;WANG Fenli(Department of Respiratory and Critical Care Medicine,Changqing Oilfield Workers'Hospital,Xi'an Shaanxi 710201)

机构地区：[1]长庆油田职工医院呼吸与危重症医学科,陕西西安710201 [2]临潼康复疗养中心疗养三科,陕西西安710600

出　　处：《医学临床研究》2024年第11期1707-1710,共4页Journal of Clinical Research

摘　　要：【目的】探讨N-乙酰半胱氨酸联合双水平气道正压通气(Bi-PAP)治疗老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的疗效及对患者免疫功能的影响。【方法】选取2021年1月至2023年1月两院收治的80例老年COPD合并呼吸衰竭患者,按照随机数字表法分为对照组(给予Bi-PAP治疗)和观察组(在对照组基础上联合N-乙酰半胱氨酸治疗),每组40例。比较两组肺功能指标[第1秒呼气容积(FEV 1)、用力肺活量(FVC)、FEV 1/FVC]、动脉血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、免疫功能指标[抗原分化簇4受体(CD4^(+))、抗原分化簇8受体(CD8^(+))、CD4^(+)/CD8^(+)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、改良英国医学研究学会呼吸困难指数(mMRC)评分、COPD患者自我评估问卷(CAT)评分及不良反应发生情况。【结果】治疗后,观察组FVC、FEV 1、FEV 1/FVC、PaO_(2)高于对照组(P<0.05),PaCO_(2)低于对照组(P<0.05)。治疗后,观察组mMRC、CAT评分低于对照组(P<0.05)。治疗后,观察组CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组SOD高于对照组,MDA低于对照组,差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】N-乙酰半胱氨酸联合Bi-PAP治疗老年COPD合并呼吸衰竭患者,不仅能有效改善患者肺功能、呼吸困难症状、动脉血气分析指标以及生活质量,还能改善患者免疫功能及氧化应激指标,且安全性较好。【Objective】To investigate the efficacy of N-acetylcysteine combined with bilateral positive airway pressure(Bi-PAP)and its influence on immune function in the treatment of elderly chronic obstructive pulmonary disease(COPD)with respiratory failure.【Methods】Eighty elderly patients with COPD and respiratory failure admitted to our hospitals from January 2021 to January 2023 were selected and divided into the control group(receiving Bi-PAP therapy)and the observation group(receiving N-acetylcysteine therapy in addition to the control group)by random number table method.The differences in pulmonary function indicators(FEV 1,FVC,FEV 1/FVC),arterial blood gas analysis indicators(PaO_(2),PaCO_(2)),immune function indicators(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),oxidative stress indicators(SOD,MDA),modified British Medical Research Council dyspnea index(mMRC)score,COPD Assessment Test(CAT)score,and incidence of adverse reactions were compared between the two groups.【Results】After treatment,the FVC,FEV 1,FEV 1/FVC,and PaO_(2)in the observation group were higher than those in the control group(P<0.05),and the PaCO_(2)in the observation group was lower than that in the control group(P<0.05).After treatment,the mMRC and CAT scores in the observation group were lower than those in the control group(P<0.05).After treatment,the CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and the CD8^(+)was lower than that in the control group,with statistically significant differences(P<0.05).After treatment,the SOD in the observation group was higher than that in the control group,and the MDA was lower than that in the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the two groups was similar,with no statistically significant difference(P>0.05).【Conclusion】The combination of N-acetylcysteine and Bi-PAP therapy in elderly patients with COPD and respiratory failure can not only effectively improve their pulmonary function,dy

关 键 词：肺疾病 慢性阻塞性/并发症 呼吸功能不全/并发症 乙酰半胱氨酸/药理学 正压呼吸 

分 类 号：R563[医药卫生—呼吸系统]