| 王飞.N-乙酰半胱氨酸对AECOPD机械通气患者炎症应激指标的影响[J].浙江中西医结合杂志,2018,28(11): |
| N-乙酰半胱氨酸对AECOPD机械通气患者炎症应激指标的影响 |
| The improved effect of N-acetylcysteine to oxidative stress of patients with acute exacerbation chronic obstructive pulmonary disease by mechanical ventilation |
| 投稿时间：2018-04-11 修订日期：2018-07-29 |
| DOI： |
| 中文关键词: 【关键词】N-乙酰半胱氨酸 慢性阻塞性肺疾病，急性加重期 机械通气 炎症应激 |
| 英文关键词:N-acetylcysteine chronic obstructive pulmonary disease, acute exacerbation mechanical ventilation oxidative stress |
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| 中文摘要: |
| 【】目的：评估N-乙酰半胱氨酸(NAC)对改善接受机械通气急性加重期慢性阻塞性肺疾病(AECOPD)患者体内炎症应激状态及肺功能的临床应用价值。方法：选择我院108例接受机械通气AECOPD患者,依据随机原则分为三组：对照组,给予常规药物治疗；大剂量组,在常规药物治疗基础上予NAC 600mg,一天三次；小剂量组,在常规药物治疗基础上予NAC 600mg,一天两次。每组均36例,疗程8周。检测并比较三组患者治疗前后血浆8-异前列腺素(8-iso-PG)、丙二醛(MDA)、超氧化物岐化酶(SOD)等氧化应激指标水平差异；血清炎性因子白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)等炎性介质指标水平差异；FEV1、FEV1%和FEV1/FVC等肺功能指标水平差异。结果：治疗前三组患者各项指标未见显著差异(P>0.05)。治疗后,大剂量组患者8-iso-PG、MDA及IL-6、IL-8、TNF-α降低幅度最明显,小剂量组次之,对照组最小(P<0.05)。治疗后大剂量组患者SOD、FEV1、FEV1%和FEV1/FVC增加幅度最明显,小剂量组次之,对照组最小(P<0.05)。结论：NAC能提高治疗接受机械通气AECOPD患者抗氧化应激能力,减少炎性因子水平,显著改善肺功能,且大剂量效应更加明显。 |
| 英文摘要: |
| Objective To analyze the improved effect of N-acetylcysteine (NAC) to oxidative stress, inflammatory response and pulmonary function of patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) by mechanical ventilation. Methods The 108 in-patients with AECOPD by mechanical ventilation were collected and divided into three groups randomly, which were control group (received the normal drug therapy), large-dosage group (received the NAC 600mg, 3 times per day based on the normal drug therapy) and small-dosage group (received the NAC 600mg, 2 times per day based on the normal drug therapy). Each group had 36 patients and the course of treatment was 8-week. The serum levels of oxidative stress (8-iso-PG, MDA and SOD) and inflammatory mediators (IL-6, IL-8 and TNF-α) and pulmonary function (FEV1, FEV1% and FEV1/FVC) were detected at pre- and post-therapy and compared among three groups. Results All indexes were no different at pre-therapy among three groups (P>0.05). At post-therapy, the reduced ranges of 8-iso-PG, MDA, IL-6, IL-8 and TNF-α in large-dosage group were the highest, and the small-dosage group were the second highest, but the control group were the lowest (P<0.05). And the increased ranges of SOD, FEV1, FEV1% and FEV1/FVC in large-dosage group were the highest, and the small-dosage group were the second highest, but the control group were the lowest (P<0.05). Conclusion N-acetylcysteine can increase antioxidant stress, reduce the inflammatory mediator levels and improve the pulmonary function in patients with AECOPD by mechanical ventilation. And the above effects of the large dosage of N-acetylcysteine are obviously. |
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