| 梁源余德文华丕虹沈珠甫苏勇王湘平.大剂量乙酰半胱氨酸对高龄患者慢性阻塞性肺病合并肺间质纤维化急
性加重期的干预作用及机制初探[J].,2011,11(19):3642-3644 |
| 大剂量乙酰半胱氨酸对高龄患者慢性阻塞性肺病合并肺间质纤维化急
性加重期的干预作用及机制初探 |
| Effects of Large Doses of Acetylcysteine on Elderly Patients with COPDCombined with Pulmonary Fibrosis in Acute Exacerbation |
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| DOI： |
| 中文关键词: 慢性阻塞性肺病（COPD） 肺间质纤维化（PIF） 乙酰半胱氨酸（NAC） |
| 英文关键词: Chronic obstructive pulmonary disease (COPD) Pulmonary fibrosis Acetylcysteine |
| 基金项目: |
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| 中文摘要: |
| 目的：观察大剂量乙酰半胱氨酸（NAC）对高龄患者慢性阻塞性肺病（COPD）合并肺间质纤维化(PIF)急性加重期的干预作
用，并对干预机制进行初步探讨。方法：年龄大于80 岁COPD 合并PIF 患者18 例，分为对照组（8 例）和观察组（10 例），对照组给
予常规治疗，观察组在对照组治疗基础上给予口服乙酰半胱氨酸颗粒600 mg/ 次，3 次/d，连用30 天，观察两组治疗前后临床症
状、肺功能指标（FVC、FEV1、FEV1/FVC）、动脉血氧分压（PaO2）、血液中细胞因子（IL-2 和TNF-α）和影像学的变化。结果：观察组
治疗总有效率和细菌培养转阴率显著升高（P<0.05）；两组治疗后FVC、FEV1、FEV1/FVC、PaO2 均较治疗前显著上升（P<0.05），血
液中IL-2 和TNF-α较治疗前显著下降（P<0.05）；组间比较存在显著性差异（P<0.05）；观察组治疗后胸部CT 见感染明显控制。结
论：在常规治疗基础上合用大剂量NAC 可以有效治疗急性加重期COPD 合并PIF 的老年患者，机制可能与抑制炎性因子表达、
减少细菌在呼吸道内的附着有关。 |
| 英文摘要: |
| Objective: To study the effects of large doses of acetylcysteine on elderly patients with chronic obstructive pulmonary
disease (COPD) combined with pulmonary fibrosis in acute exacerbation and its possible mechanism. Methods: 18 cases(ages≥80) COPD
with PIF were ran- domly divided into control group 8 cases (treated with conventional therapy only) and observation group 10 cases
(treated with the con- ventional method and NAC 600 mg/per time, 3 times per-day orally for 30 days to observe the change of clinical
symptoms, bacterial number and CT, and the levels of FVC, FEV1, FEV1/FVC, PaO2, IL-2 and TNF-α. Results: The achievement rate
of clinical symptoms, bacterial number after treatment were higher than those in control group （P<0.05)．The levels of FVC, FEV1,
FEV1/FVC, PaO2 after treatment were significantly higher than than those before treatment in two groups (P<0.05), meanwhile IL-2 and
TNF-αlevels in blood were lower than those before treatment(P<0.05), and there was significant difference in two groups(P<0.05). And
the CT changes in chest were much more significant. Conclusion: High dose NAC with conventional therapy has obviously effects on
acute COPD with PIF of eld patients, the effect may be ascribed to the reduction of inflammatory factor and bacteria adhesion partly. |
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