N-乙酰半胱氨酸辅助治疗老年慢性肺源性心脏病的疗效及其对炎症因子、血管活性因子的影响

摘要

Objective To observe the effects of N-acetylcysteine(NAC) as adjuvant therapy on efficacy,inflammatory factors and vasoactive factors in elderly patients with chronic pulmonary heart disease.Methods A total of 172 elderly patients with chronic pulmonary heart disease were randomly divided into observation group and control group,with 86 cases in each group.Both groups received conventional therapy,and the observation group was orally administered NAC at the same time.The treatment lasted for four weeks in both groups.Before and after treatment,the lung function indices[including forced expiratory volume in one second(FEV1),FEV1/forced vital capacity (FEV1/FVC) and peak expiratory flow(PEF)],inflammatory factors[including interleukin-8(IL-8) and tumor necrosis factor alpha (TNF-α)] and vasoactive factors[including endothelin(ET) and angiotensinⅡ(AngⅡ)] were compared between the two groups.The efficacy and the 2-year survival rate of follow-up were also compared between the two groups.Results After four weeks of treatment,the FEV1,FEV1/FVC and PEF of both groups were higher than those before treatment(all P<0.05),and the lung function indices of the observation group were higher than those of the control group(P<0.05).The levels of serum IL-8 and TNF-α,and plasma ET and AngⅡin both groups decreased compared to those before treatment(P<0.05),and the indices above of the observation group were lower than those of the control group(P<0.05).The total effective rate and 2-years survival rate of the observation group were higher than those of the control group(all P<0.05).Conclusion The adjuvant therapy of NAC can effectively improve the pulmonary function and inflammatory response,improve the efficacy,and prolong the survival time in elderly patients with chronic pulmonary heart disease.%目的 观察N-乙酰半胱氨酸(NAC)辅助治疗老年慢性肺源性心脏病的疗效及其对炎症因子、血管活性因子的影响.方法 将172例老年慢性肺源性心脏病患者随机分为观察组和对照组各86例.两组均给予常规治疗,观察组同时给予NAC口服,疗程均4周.比较两组患者治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量比值(FEV1/FVC)、呼气峰流量(PEF)]、炎性细胞因子[白细胞介素(IL-8)、肿瘤坏死因子(TNF-α)]以及血管活性因子[内皮素(ET)、血管紧张素Ⅱ(AngⅡ)]水平;比较两组患者的疗效及随访2年生存率.结果 治疗4周后,两组患者FEV1、FEV1/FVC及PEF均较治疗前升高(均P<0.05),且观察组肺功能指标高于对照组;两组血清IL-8、TNF-α及血浆ET、AngⅡ水平则较治疗前降低(P<0.05),且观察组以上指标低于对照组(均P<0.05).观察组患者总有效率及2年生存率高于对照组(均P<0.05).结论 NAC辅助治疗可有效改善老年慢性肺源性心脏病患者的肺功能和炎症反应,提高疗效,延长患者生存时间.