Effect of acetylcysteine effervescent tablets combined with beclomethasone suspension on immune function,erythrocyte sedimentation rate,and procalcitonin levels in patients with chronic obstructive pulmonary disease
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目的 探讨乙酰半胱氨酸泡腾片联合倍氯米松混悬液对慢性阻塞性肺疾病(COPD)患者免疫功能及红细胞沉降率(ESR)、降钙素原(PCT)水平的影响.方法 回顾性分析2022年1月至2023年6月义乌市中心医院收治的COPD患者102例的临床资料,根据治疗方法的不同将其分为A组(n=51)、B组(n=51).A组:对症治疗+倍氯米松混悬液,B组:A组+乙酰半胱氨酸泡腾片.比较两组患者的临床疗效、运动耐力、临床症状、生活质量、免疫功能、血清ESR、PCT水平.结果 B组总有效率为96.08％(49/51),明显高于A组的82.35％(42/51)(x2=5.14,P＜0.05).A组治疗后的6min步行试验(6MWT)、CD3+、CD4+及CD4+/CD8+[(317.19±46.70)m、(54.53±7.98)％、(34.76±4.23)％、(1.20±0.28)]均明显长于、高于治疗前[(266.49±43.01)m、(49.38±8.27)％、(28.75±3.33)％、(0.85±0.21)](t6WMT=5.70、tCD3+=3.20,tCD4+=7.97,tCD4+/CD8+=7.14,均 P＜0.001).B 组治疗后的 6MWT、CD3+、CD4+及 CD4+/CD8+[(328.19±41.48)m、(60.02±5.17)％、(36.89±5.59)％、(1.37±0.27)]均明显长于、高于治疗前[(265.69±49.60)m]、(44.33±7.34)％、(28.59±4.35)％、(0.83±0.12)](t6WMT=6.90、tCD3+=12.48,tCD4+=8.36,tCD4+/CD8+=13.05,均 P＜0.001);且 B 组治疗后 6MWT、CD3+、CD4+及 CD4+/CD8+均长于、高于 A 组(t6WMT==3.35,tCD3+=10.94,tCD4+=5.83,tCD4+/CD8+=8.42,均P＜0.05).A组患者治疗后的改良版英国医学研究会呼吸问卷(mMRC)、COPD 评估测试(CAT)评分、CD8+、ESR、PCT[(1.30±1.04)分、(14.37±4.58)分、(30.61±8.32)％、(24.28±4.88)mm/h、(0.44±0.16)µg/L]均明显低于治疗前[(2.53±0.85)分、(20.10±6.34)分、(35.90±9.71)％、(33.26±6.28)mm/h、(0.72±0.16)µg/L](4mMRC=6.54、tCAT=5.23、tCD8+=4.21、tESR=8.06、tPCT=8.83,均P＜0.05).B 组患者治疗后的 mMRC、CAT 评分、CD8+、ESR、PCT[(1.09±0.90)分、(13.58±3.59)分、(27.63±5.24)％、(23.16±6.71)mm/h、(0.34±0.14)µg/L]均明显低于治疗前[(2.47±0.93)分、(19.93±4.60)分、(34.93±5.52)％、(33.25±77.59)mm/h、(0.72±0.12)](tmMRC=7.61、tCAT=7.77、tCD8+=6.85、tESR=7.11、tPCT=14.71,均P＜0.05);且 B 组治疗后的 mMRC、CAT 评分、CD8+、ESR、PCT 均明显低于 A 组(tmMRC=2.87、tCAT=2.57、tCD8+=5.74、tESR=2.57、tPCT=8.77,均P＜0.05).结论 乙酰半胱氨酸泡腾片联合倍氯米松治疗COPD患者具有明显的临床疗效,在提高运动耐力、改善临床症状、生活质量及免疫功能方面具有明显效果.
Objective To investigate the effect of acetylcysteine effervescent tablets combined with beclomethasone suspension on immune function,erythrocyte sedimentation rate(ESR),and procalcitonin(PCT)levels in patients with chronic obstructive pulmonary disease(COPD).Methods The clinical data of 102 patients with COPD admitted to Yiwu Central Hospital from January 2022 to June 2023 were retrospectively analyzed.These patients were divided into Group A(n=51)and Group B(n=51)based on different treatment methods.Group A received symptomatic treatments and beclomethasone suspension,while Group B received the same treatment as Group A plus acetylcysteine effervescent tablets.The clinical efficacy,exercise tolerance,clinical symptoms,quality of life,immune function,and serum ESR and PCT levels were compared between Groups A and B.Results The total response rate in Group B was 96.08％(49/51),which was significantly higher than that in Group A[82.35％(42/51),x2=5.14,P＜0.05].After treatment,Group A showed significantly longer distance in the 6-minute walk test(6MWT)and higher levels of CD3+,CD4+,and CD4+/CD8+ratio[(317.19±46.70)m,(54.53±7.98)％,(34.76±4.23)％,(1.20±0.28)]compared with before treatment[(266.49±43.01)m,(49.38±8.27)％,(28.75±3.33)％,(0.85±0.21)](t6MWT=5.70,tCD3+=3.20,tCD4+=7.97,tCD4+/CD8+=7.14,all P＜0.001).Group B exhibited significantly longer distance in the 6MWT as well as higher levels of CD3+,CD4+,and CD4+/CD8+ratio after treatment[(328.19±41.48)m,(60.02±5.17)％,(36.89±5.59)％,(1.37±0.27)]compared with before treatment[(265.69±49.60)m,(44.33±7.34)％,(28.59±4.35)％,(0.83±0.12)](t6MWT=6.90,tCD3+=12.48,tCD4+=8.36,tCD4+/CD8+=13.05,all P＜0.001).After treatment,the distance in 6MWT and the levels of CD3+,CD4+,and CD4+/CD8+in Group B were significantly longer or higher compared with Group A(t6MWT=3.35,tCD3+=10.94,tCD4+=5.83,tCD4+/CD8+=8.42,all P＜0.05).After treatment,Modified British Medical Research Council Questionnaire(mMRC)score,CAT score,CD8+,ESR,and PCT in group A[(1.30±1.04)points,(14.37±4.58)points,(30.61±8.32)％,(24.28±4.88)mm/h,(0.44±0.16)μg/L]were significantly decreased compared with before treatment[(2.53±0.85)points,(20.10±6.34)points,(35.90±9.71)％,(33.26±6.28)mm/h,(0.72±0.16)pg/L,tmMRC=6.54,tCAT=5.23,tCD8+=4.21,tESR=8.06,tPCT=8.83,all P＜0.05).After treatment,mMRC score,CAT score,CD8+,ESR,and PCT in group B[(1.09±0.90)points,(13.58±3.59)points,(27.63±5.24)％,(23.16±6.71)mm/h,(0.34±0.14)µg/L]were significantly decreased compared with before treatment[(2.47±0.93)points,(19.93±4.60)points,(34.93±5.52)％,(33.25±77.59)mm/h,(0.72±0.12),tmMRC=7.61,tCAT=7.77,tCD8+=6.85,tESR=7.11,tPT=14.71,all P＜0.05).After treatment,mMRC score,CAT score,CD8+,ESR,and PCT in group B were significantly lower compared with group A(tmMRC=2.87,tCAT=2.57,tCD8+=5.74,tESR=2.57,tPCT=8.77,all P＜0.05).Conclusion The combination of acetylcysteine effervescent tablets and beclomethasone demonstrates obvious clinical efficacy in the treatment of COPD patients.The combined therapy effectively improves patients'exercise endurance,clinical symptoms,quality of life,and immune function.
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