N-乙酰半胱氨酸治疗AECOPD合并呼吸衰竭患者的临床研究  

Clinical trial of N-acetylcysteine in the treatment of patients with AECOPD and respiratory failure

作　　者：马群[1] 李卫阳[1] 许蒙[1] 陈慧[1] 王婧 MA Qun;LI Wei-yang;XU Meng;CHEN Hui;WANG Jing(Second Department of Respiratory and Critical Care Medicine,Nanyang First People's Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市第一人民医院呼吸与危重症医学二科,河南南阳473000

出　　处：《中国临床药理学杂志》2025年第5期606-610,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察吸入用N-乙酰半胱氨酸溶液联合布地奈德混悬液和特布他林吸入用溶液治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭(RF)患者的临床疗效及安全性。方法将AECOPD合并RF患者按照队列法分为试验组和对照组。在基础治疗基础上,对照组给予布地奈德混悬液,每次1 mg,bid,雾化吸入治疗+特布他林雾化吸入用溶液,每次5 mg,bid,雾化吸入治疗;试验组在对照组治疗的基础上,给予吸入用N-乙酰半胱氨酸溶液,每0.3 g,bid,雾化吸入治疗。2组患者均治疗2周。比较2组患者治疗后的临床疗效、肺功能指标[用力肺活量(FVC)、呼气峰值流速(PEF)]、呼吸困难程度[改良英国医学研究委员会呼吸困难量表(mMRC)评分]、氧化应激反应指标[超氧化物歧化酶(SOD)]、炎症反应指标[超敏C反应蛋白(hs-CRP)],并评价安全性。结果对照组入组56例、试验组入组64例。治疗后,试验组和对照组的总有效率分别为93.75%(60例/64例)和82.14%(46例/56例),在统计学上差异有统计学意义(P<0.05)。治疗后,试验组和对照组的FVC分别为(2.41±0.59)和(2.08±0.54)L,PEF分别为(4.97±1.18)和(4.08±1.12)L·s^(-1),mMRC评分分别为(1.86±0.39)和(2.67±0.56)分,血清SOD含量分别为(97.54±8.03)和(79.02±7.27)U·L^(-1),血清hs-CRP含量分别为(5.09±1.42)和(8.63±2.13)mg·L^(-1),试验组的上述指标与对照组比较,在统计学上差异均有统计学意义(均P<0.001)。试验组的药物不良反应主要有呕吐、皮疹、心悸、恶心,对照组的药物不良反应主要有乏力、胃肠道反应、皮疹。试验组和对照组的药物不良反应总发生率分别为10.94%(7例/64例)和8.93%(5例/56例),在统计学上差异无统计学意义(P>0.05)。结论吸入用N-乙酰半胱氨酸溶液联合布地奈德混悬液和特布他林吸入用溶液治疗AECOPD合并RF的临床疗效确切,能促进患者肺功能恢复,减轻呼吸困难程度,减轻氧化应激及炎症反应。Objective To observe the clinical effect and safety ofN-acetylcysteine combined with budesonide and terbutaline in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure(RF).Methods According to queuing method,patients with AECOPD and RF were divided into treatment group and control group.On basis of basic treatment,control group was given aerosol inhalation of budesonide suspension(1 mg/once,bid)and terbutaline solution(5 mg/once,bid),while treatment group was given aerosol inhalation ofN-acetylcysteine solution(0.3 g/once,bid)on basis of control group.All patients were treated for 2 weeks.The clinical effect,pulmonary function indexes[forced vital capacity(FVC),peak expiratory flow(PEF)],dyspnea degree[modified version of British medical research council dyspnea scale(mMRC)],oxidative stress response indexes[superoxide dismutase(SOD)]and inflammatory response indexes[hypersensitive C-reactive protein(hs-CRP)]were compared between the two groups after treatment,and safety was evaluated.Results There were 56 cases in control group and 64 cases in treatment group.After treatment,the total effective rate of the treatment group and the control group were 93.75%(60 cases/64 cases)and 82.14%(46 cases/56 cases),respectively,and the difference was statistically significant(P<0.05).After treatment,FVC in treatment group and control group were(2.41±0.59)and(2.08±0.54)L;PEF were(4.97±1.18)and(4.08±1.12)L·s^(-1);mMRC scores were(1.86±0.39)and(2.67±0.56)points;SOD levels were(97.54±8.03)and(79.02±7.27)U·L^(-1);hs-CRP levels were(5.09±1.42)and(8.63±2.13)mg·L^(-1).Compared with control group,the above indexes in treatment group were statistically significant(allP<0.001).The adverse drug reactions in treatment group were mainly on vomiting,rash,palpitation and nausea,while in control group were mainly on fatigue,gastrointestinal reactions and rash.There was no significant difference in total incidence of adverse drug reactions between treatment grou

关 键 词：吸入用N-乙酰半胱氨酸溶液 布地奈德混悬液 特布他林雾化吸入用溶液 慢性阻塞性肺疾病急性加重期 呼吸衰竭 临床疗效 

分 类 号：R974[医药卫生—药品]