CAJ | 학술논문

目的探讨联合应用沙美特罗-氟替卡松、N-乙酰半胱氨酸对稳定期慢性阻塞性肺疾病(COPD)患者的肺功能、体内氧化-抗氧化状态、气道炎症以及生存质量的影响.方法将60例稳定期COPD患者,以双盲随机方式分为对照组(30例)和治疗组(30例),对照组使用沙美特罗-氟替卡松吸入剂,治疗组在此基础上联合使用N-乙酰半胱氨酸,对比观察治疗4周后患者肺功能、血清和诱导痰上清液中IL-8、肿瘤坏死因子-α、超氧化物歧化酶和丙二醛以及诱导痰沉渣涂片中自细胞及其分类的变化,并进行生存质量的评估.结果治疗后对照组第一秒用力呼气容积(FEV1)、FEV1占预计值%、生存质量评分、诱导痰上清液中IL-8、肿瘤坏死因子-α、痰涂片中细胞总数和中性粒细胞比例与治疗前比较差异有统计学意义(P<0.05或<0.01);治疗组FEV1、FEV1占预计值%、生存质量评分、血清超氧化物歧化酶和丙二醛、诱导痰卜清液中IL-8、肿瘤坏死因子-α、血清超氧化物歧化酶、丙二醛以及痰涂片中细胞总数和中性粒细胞比例、巨噬细胞比例,治疗前后差异具有统计学意义(P<0.05或<0.01).治疗后,治疗组血清超氧化物歧化酶[(93±8)×10M-6U/L]和丙二醛[(4.0±1.0)×10-3mmol/L]、痰涂片中中性粒细胞百分比(0.5±0.3)与对照组[(85±10)×10-6U/L、(4.2 ±1.1)×10-3mmol/L、0.6±0.2]比较差异具有统计学意义(P<0.05).结论沙美特罗-氟替卡松与N-乙酰半胱氨酸联合应用对稳定期COPD患者的肺功能、体内氧化-抗氧化状态及其气道炎症均具有较好的作用,且能够较明显改善患者的生存质最,尤其在降低痰液中中性粒细胞比例、减轻体内氧化应激反应方面明显优于单用沙美特罗和氟替卡松.
목적 탐토연합응용사미특라-불체잡송、N-을선반광안산대은정기만성조새성폐질병(COPD)환자적폐공능、체내양화-항양화상태、기도염증이급생존질량적영향.방법 장60례은정기COPD환자,이쌍맹수궤방식분위대조조(30례)화치료조(30례),대조조사용사미특라-불체잡송흡입제,치료조재차기출상연합사용N-을선반광안산,대비관찰치료4주후환자폐공능、혈청화유도담상청액중IL-8、종류배사인자-α、초양화물기화매화병이철이급유도담침사도편중자세포급기분류적변화,병진행생존질량적평고.결과 치료후대조조제일초용력호기용적(FEV1)、FEV1점예계치%、생존질량평분、유도담상청액중IL-8、종류배사인자-α、담도편중세포총수화중성립세포비례여치료전비교차이유통계학의의(P<0.05혹<0.01);치료조FEV1、FEV1점예계치%、생존질량평분、혈청초양화물기화매화병이철、유도담복청액중IL-8、종류배사인자-α、혈청초양화물기화매、병이철이급담도편중세포총수화중성립세포비례、거서세포비례,치료전후차이구유통계학의의(P<0.05혹<0.01).치료후,치료조혈청초양화물기화매[(93±8)×10M-6U/L]화병이철[(4.0±1.0)×10-3mmol/L]、담도편중중성립세포백분비(0.5±0.3)여대조조[(85±10)×10-6U/L、(4.2 ±1.1)×10-3mmol/L、0.6±0.2]비교차이구유통계학의의(P<0.05).결론 사미특라-불체잡송여N-을선반광안산연합응용대은정기COPD환자적폐공능、체내양화-항양화상태급기기도염증균구유교호적작용,차능구교명현개선환자적생존질최,우기재강저담액중중성립세포비례、감경체내양화응격반응방면명현우우단용사미특라화불체잡송.
Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.