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目的探讨N-乙酰半胱氨酸对慢性阻塞性肺疾病急性加重期(AECOPD)患者血清氧化物质水平的影响。方法选取2013年4月—2015年6月上海交通大学医学院附属同仁医院收治的AECOPD患者108例,采用随机数字表法分为对照组和观察组,各54例。对照组患者在常规对症治疗基础上应用氨溴索治疗,观察组患者在常规对症治疗基础上应用N-乙酰半胱氨酸治疗,比较两组患者临床疗效及治疗前后血清氧化物质水平。结果两组患者临床疗效比较,差异无统计学意义(u=-0.334,P=0.737)。两组患者治疗前血清谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、丙二醛(MDA)及活性氧类物质(ROS)水平比较,差异无统计学意义(P>0.05);观察组患者治疗后血清GSH-PX、SOD水平高于对照组,血清MDA、ROS水平低于对照组(P<0.05)。结论 N-乙酰半胱氨酸可明显优化AECOPD患者血清氧化物质水平,减轻肺部氧化损伤,改善病情。
Objective To investigate the effect of N-acetylcysteine on serum oxidant levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 108 patients with AECOPD admitted to Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine from April 2013 to June 2015 were randomly divided into control group and observation group with 54 cases in each group. Patients in the control group were treated with ambroxol on the basis of conventional symptomatic treatment. Patients in the observation group were treated with N-acetylcysteine on the basis of conventional symptomatic treatment. The clinical efficacy and serum levels of oxidized substances before and after treatment were compared between the two groups. Results There was no significant difference in clinical efficacy between the two groups (u = -0.334, P = 0.737). There were no significant differences in the levels of serum glutathione peroxidase (GSH-PX), superoxide dismutase (SOD), malondialdehyde (MDA) and reactive oxygen species (ROS) (P> 0.05). Serum levels of GSH-PX and SOD in the observation group were significantly higher than those in the control group, serum MDA and ROS levels were lower than those in the control group (P <0.05). Conclusion N-acetylcysteine can significantly improve serum oxidant levels in AECOPD patients, reduce oxidative damage in the lungs, and improve the condition.