目的:探究特布他林联合N-乙酰半胱氨酸(N-Acetyl-cysteine,NAC)治疗老年慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)对患者血气指标及气道重塑指标的影响.方法:选取 2020 年3 月～2022 年3 月在我院进行诊治的 94 例COPD老年患者作为研究对象,采用随机数字表法随机分为研究组和对照组,各 47例.对照组采用特布他林进行治疗,研究组在对照组的基础上联合NAC进行治疗.比较两组治疗前后的肺功能水平、血气指标、气道重塑指标、咳嗽咳痰症状程度、患者生活质量以及治疗期间不良反应情况.结果:治疗后,两组的第 1 s用力呼气容积(Forced expiratory volume in one second,FEV1)、用力肺活量(Forced vital capacity,FVC)、FEV1/FVC、动脉血氧分压(Arterial partial pressure oxygen,PaO2)、咳嗽和咳痰的评估问卷(Cough and sputum assessment questionnaire,CASA-Q)总分明显升高,且研究组高于对照组(P＜0.05).两组的动脉血二氧化碳分压(Partial Pressure of carbon dioxide in arterial blood,PaCO2)、血清基质金属蛋白酶 3(Matrix metalloprpteinase-3,MMP-3)、基质金属蛋白酶 9(Matrix metalloprpteinase-9,MMP-9)、基质金属蛋白酶组织抑制剂 1(Tissue Inhibitor of Metalloproteinase-1,TIMP-1)、转化生长因子-β(Transforming Growth Factor-β,TGF-β)水平和COPD患者自我评估测试(COPD Assessment Test,CAT)问卷评分均明显降低,且研究组明显低于对照组(P＜0.05).治疗期间,两组不良反应发生情况无明显差异(P＞0.05).结论:特布他林联合 NAC 治疗老年 COPD 治疗效果和安全性均属良好,可以增强患者肺功能,提升其肺部气体交换功能,并遏制气道重塑作用,对缓解咳嗽和咳痰症状提升生活质量有积极意义.
Effects of terbutaline combined with N-acetylcysteine on blood gas indicators and airway remodeling indicators in treating elderly chronic obstructive pulmonary disease
Objective:To explore the effects of terbutaline combined with N-acetylcysteine(NAC)on blood gas indicators and airway remodeling indicators in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:A total of 94 elderly patients with COPD who were diagnosed and treated in our hospital between March 2020 and March 2022 were selected as research subjects,and were randomly divided into study group and control group by the random number table method,with 47 cases in each group.The control group was treated with terbutaline,and the study group was given NAC on the basis of the control group.The pulmonary function,blood gas indicators,airway remodeling indicators,cough and sputum symptoms and quality of life before and after treatment and adverse reactions during treatment were compared between the two groups.Results:After treatment,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC,arterial partial pressure of oxygen(PaO2)and total score of Cough and Sputum Assessment Questionnaire(CASA-Q)in both groups were significantly increased,and the above indicators in study group were higher than those in control group(P<0.05).The arterial partial pressure of carbon dioxide in blood(PaCO2),matrix metalloprpteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),transforming growth factor-β(TGF-β)and score of COPD Assessment Test(CAT)were significantly decreased in the two groups,and the indicators were significantly lower in study group than those in control group(P<0.05).During treatment,there were no significant differences in the adverse reactions between the two groups(P>0.05).Conclusion:Terbutaline combined with NAC has good efficacy and safety in the treatment of elderly COPD.It can enhance the pulmonary function,improve the pulmonary gas exchange function,and inhibit the airway remodeling,and it has positive significance on relieving the cough and sputum symptoms and improving the quality of life.
NETL
NSTL
万方数据
维普
