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目的:研究探讨乙酰半胱氨酸片抗氧化联合BiPAP呼吸机治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSAS)重叠综合征(COPD-OSAS)的临床治疗效果。方法:平行开放的方法选取某院2008-2010年COPD-OSAS重叠综合征160例,随机分为乙酰半胱氨酸片联合BiPAP呼吸机组(A组)40例、单用乙酰半胱氨酸片组(B组)40例、单用BiPAP呼吸机组(C组)40例和常规治疗组(D组)40例;观察记录入院时及治疗2周结束时患者的临床症状、氧化/抗氧化指标(SOD)、内皮素(ET-1)、多导睡眠检测PSG(SEF、TDB、SLT90%)和肺功能(FEV1%、FEV1/FVC)等方面有无差异。结果:(1)4组治疗前、后SOD、ET-1差异有显著性(P<0.05);且各组治疗后SOD、ET-1差异有显著性(P<0.05);其中A组SOD、ET-1下降幅度明显高于B组和C组。(2)4组治疗前、后多导睡眠监测、肺功能资料差异有显著性(P<0.05);而且各组治疗后多导睡眠监测、肺功能资料差异有显著性(P<0.05);其中A组SEF、FEV1%和FEV1/FVC上升幅度明显高于B组和C组,而A组TDB、SLT90%下降幅度明显高于B组和C组。结论:乙酰半胱氨酸片抗氧化联合BiPAP呼吸机治疗重叠综合征有较好的临床疗效,在呼吸科领域具有广泛的应用前景,值得临床推广。
Objective: To investigate the clinical effect of acetylcysteine tablets combined with BiPAP ventilator in the treatment of chronic obstructive pulmonary disease (COPD) complicated with obstructive sleep apnea (OSAS) overlap syndrome (COPD-OSAS). Methods: 160 cases of COPD-OSAS overlap syndrome in a hospital from 2008 to 2010 were randomly divided into 40 cases of acetylcysteine combined with BiPAP ventilator (group A) and 40 cases of single-use acetylcysteine 40 patients in group B (group B), 40 patients in group B (group B) and 40 patients in group D (group D). The clinical symptoms, the indexes of oxidation and anti-oxidation There was no difference in SOD, ET-1, PSG (SEF, TDB, SLT90%) and pulmonary function (FEV1 / FVC) Results: (1) There were significant differences in SOD and ET-1 levels between the four groups before and after treatment (P <0.05), and the differences of SOD and ET-1 between the four groups after treatment were significant , ET-1 decreased significantly higher than the B group and C group. (2) The polysomnography and pulmonary function data of the 4 groups before and after treatment were significantly different (P <0.05). The polysomnography and pulmonary function data of the four groups were significantly different after treatment (P <0.05). The increase of SEF, FEV1% and FEV1 / FVC in group A was significantly higher than that in group B and C, while the decrease of TDB and SLT90% in group A was significantly higher than that in group B and C. CONCLUSION: Acetylcysteine tablets combined with BiPAP respirator has good clinical efficacy in the treatment of overlap syndrome and has broad application prospects in the field of respiratory medicine. It is worthy of clinical promotion.