N-乙酰半胱氨酸对慢性阻塞性肺疾病患者呼吸道病原菌抑制作用的影响因素分析

目的:分析N-乙酰半胱氨酸(NAC)对慢性阻塞性肺疾病(COPD)患者呼吸道病原菌抑制作用的影响因素。方法:选择重症COPD呼吸道感染的90例患者作为研究对象,采集所有患者痰液标本进行菌株分离培养,并观察不同浓度、作用时间、有机物质、pH值及存放条件对NAC抑菌效果的影响。结果:90例老年重症COPD呼吸道感染患者,共培养分离出98株病原菌,其中革兰阳性菌25株(25.51%),革兰阴性菌57株(58.16%),真菌16例(16.33%);5 mg/mL的NAC溶液对COPD呼吸道感染常见病原菌抑菌率几乎均能达到100%;2 mg/mL的NAC溶液对金黄色葡萄球菌和大肠埃希菌作用0.5 h后即表现出十分明显抑菌效果;有机物质达到8.0%以上时,NAC抑菌效果明显降低;pH为4.0时,NAC抑菌作用十分明显;NAC溶液密封冷藏3 d后抑菌效果仍然较好,但室温存放1 d后抑菌效果明显下降。结论:NAC对重症COPD呼吸道感染常见病原菌均具有理想抑菌效果,有机物质、pH值以及存放条件均对NAC抑菌效果有明显影响。

Factors influencing the inhibitory effect of N acetylcyanine on respiratory pathogens in patients with chronic obstructive pulmonary disease

Objective: To investigate the factors influencing the inhibitory effect of N-acetylcyanine (NAC) on respiratory pathogens in patients with chronic obstructive pulmonary disease (COPD). Methods: Ninety patients with severe COPD respiratory infection were selected. Sputum specimens from all patients were collected and strains were separated and cultured. The influences on NAC inhibitory effects from different concentrations, action time, organic matter, pH value and storage conditions were observed. Results: Ninety-eight strains of pathogenic bacteria were isolated and cultured from the 90 patients with severe COPD respiratory infection. There were 25 strains of Gram-positive bacteria (25.51%), 57 strains of Gram-negative bacteria (58.16%), and 16 strains of fungi (16.33%). The bactericidal rate of 5mg/mL NAC solution to the common pathogenic bacteria of COPD respiratory tract was almost 100%. The inhibitory effect of 2mg/mL NAC solution on aphylococcus aureus and scherichia coli was significant after 30 min. When the organic matter was above 8%, the inhibitory effect of NAC was obviously reduced. When the pH was 4, the inhibitory effect of NAC was very obvious. The inhibitory effect of NAC solution was still good after being sealed and refrigerated for 3 days, but the inhibitory effect decreased obviously after 1-day storage at room temperature. Conclusion: NAC has an ideal inhibitory effect on the common pathogenic bacteria of severe COPD respiratory infection, while organic matters, pH value and storage conditions have an obvious effect on the inhibitory effect of NAC.