CAJ | 학술논문

目的：观察和分析N-乙酰半胱氨酸（NAC）辅助治疗慢性阻塞性肺疾病急性加重（AECOPD）患者的疗效及对氧化应激、肺功能的影响。方法选取100例AECOPD患者作为研究对象，将其随机分为观察组和对照组，每组50例，2组患者均给予常规对症治疗，观察组在此基础上给予口服NAC治疗。根据2组患者治疗前、后临床症状的变化进行疗效评价；对2组患者治疗前后的第一秒钟用力呼气容积（FEV1）、第一秒钟用力呼吸容积占用力肺活量的比值（FEV1/FEC％）和FEV1占预计值百分比等肺功能指标进行检测；对2组患者血清标本中的谷胱甘肽硫转移酶（GSH-ST ）活力、抑制羟自由基能力和抗超氧阴离子自由基能力等抗氧化应激指标进行检测。结果经治疗，2组的临床有效率分别为94％和72％，观察组的临床有效率显著高于对照组（P＜0．05），而且观察中疗效为“显效”的患者比例显著高于对照组（P＜0．05），疗效为“有效”或“无效”的患者比例显著低于对照组（P＜0．05）；2组患者的各项肺功能指标均较治疗前显著提高（P＜0．05），而且治疗后观察组患者的各项肺功能指标均显著高于对照组（P＜0．05）；2组患者的各项抗氧化应激指标均较治疗前显著提高（P＜0．05），而且治疗后观察组患者的各项抗氧化应激指标均显著高于对照组（P＜0．05）。结论应用NAC辅助治疗AECOPD具有显著的疗效，可显著改善患者的肺功能，缓解患者的氧化应激反应。
목적：관찰화분석N-을선반광안산（NAC）보조치료만성조새성폐질병급성가중（AECOPD）환자적료효급대양화응격、폐공능적영향。방법선취100례AECOPD환자작위연구대상，장기수궤분위관찰조화대조조，매조50례，2조환자균급여상규대증치료，관찰조재차기출상급여구복NAC치료。근거2조환자치료전、후림상증상적변화진행료효평개；대2조환자치료전후적제일초종용력호기용적（FEV1）、제일초종용력호흡용적점용력폐활량적비치（FEV1/FEC％）화FEV1점예계치백분비등폐공능지표진행검측；대2조환자혈청표본중적곡광감태류전이매（GSH-ST ）활력、억제간자유기능력화항초양음리자자유기능력등항양화응격지표진행검측。결과경치료，2조적림상유효솔분별위94％화72％，관찰조적림상유효솔현저고우대조조（P＜0．05），이차관찰중료효위“현효”적환자비례현저고우대조조（P＜0．05），료효위“유효”혹“무효”적환자비례현저저우대조조（P＜0．05）；2조환자적각항폐공능지표균교치료전현저제고（P＜0．05），이차치료후관찰조환자적각항폐공능지표균현저고우대조조（P＜0．05）；2조환자적각항항양화응격지표균교치료전현저제고（P＜0．05），이차치료후관찰조환자적각항항양화응격지표균현저고우대조조（P＜0．05）。결론응용NAC보조치료AECOPD구유현저적료효，가현저개선환자적폐공능，완해환자적양화응격반응。
Obj ective To observe and analyze the curative effect of N-acetylcysteine (NAC) on adj uvant treatment of the patients with acute exacerbation of chronic obstructive pulmonary dis-ease (AECOPD)and its influence on oxidative stress and pulmonary function.Methods 100 AE-COPD patients were selected as the research obj ects and randomly divided into the observation group and the control group,50 cases in each group.The patients in the two groups were treated with the conventional treatment,and the patients in the observation group were treated with the oral NAC treatment on the basis of the conventional treatment.The curative effect of the patients was evaluat-ed according to the change of the clinical symptoms before and after the treatment,the pulmonary function indexes of forced expiratory volume in one second (FEV1 ),the first second forced respira-tory volume ratio of forced vital capacity (FEV1/FEC%)and FEV1 percentage of the patients in the two groups before and after the treatment were detected.The anti oxidative stress indexes of glu-tathione transferase (GSH-ST)activity,inhibition of hydroxyl radicals and the ability of anti super-oxide anion free radicals in serum specimens of the patients were detected.Results After the treat-ment, the clinical efficacy of the two groups were 94% and 72%, the clinical efficacy of the observation group was significantly higher than that of the control group (P<0 .0 5 ).The proportion of the patients with the curative effect of“significant ”in the observation group was significantly higher than that of the control group (PP<0 .05 ),and the proportion of the pa-tients with the curative effect of“effective”or“invalid”in the observation group was significantly lower than that of the control group (P<0 .05 ).The pulmonary function indexes of the patients in the two groups significantly improved (P<0 .05 ),and the pulmonary function indexes of the patients in the observation group were significantly higher than those of the control group (P <0 .05 ).The anti oxidative stress indexes of the patients in the two groups significantly improved (P<0 .05 ),and anti oxidative stress indexes of the patients in the observation group were signif-icantly higher than those of the control group (P<0 .05 ).Conclusion Application of NAC in adjuvant treatment of AECOPD can achieve significant curative effect,improve the lung function of patients significantly and alleviate the oxidative stress of the patients.