乙酰半胱氨酸辅助治疗对老年COPD稳定期病人肺动脉压力、右心室射血分数和血清CRP、SOD水平的影响

目的观察乙酰半胱氨酸对老年慢性阻塞性肺疾病（COPD）稳定期病人肺动脉压力（PASP）、右心室射血分数（RVEF）和血清C反应蛋白（CRP）、过氧化物歧化酶（SOD）水平的影响，探讨其临床应用价值。方法选择老年COPD稳定期病人共66例为研究对象。将病人随机分为对照组和观察组，每组33例。对照组病人给予常规治疗，观察组在常规治疗基础上加用乙酰半胱氨酸片口服，疗程2个月。分别于治疗前及治疗后1个月、2个月，运用心脏彩超测定2组病人的PASP、RVEF的变化，并检测其血清CRP、SOD水平的变化。结果治疗后2组的PASP、CRP均较治疗前下降，但仅治疗2个月后PASP、CRP的下降观察组较对照组差异有统计学意义（P < 0.05和P < 0.01）。治疗后2组的SOD均较治疗前上升，且SOD的上升观察组较对照组差异有统计学意义（P < 0.05和P < 0.01）。治疗后RVEF的上升在2组内及组间差异均无统计学意义（P>0.05）。结论联合使用乙酰半胱氨酸治疗老年COPD稳定期病人有利于肺动脉压力的控制，且可能通过抑制炎症反应、改善抗氧化能力而实现，对于此类病人具有临床应用价值。

Effect of acetylcysteine adjuvant therapy on pulmonary artery pressure,right ventricular ejection fraction and serum levels of CRP and SOD in elderly patients with COPD at stable stage

ObjectiveTo observe the effects of acetylcysteine adjuvant therapy on pulmonary artery pressure(PASP), right ventricular ejection fractions(RVEF) and serum levels of C-reactive protein(CRP) and superoxide dismutase(SOD) in elderly patients with chronic obstructive pulmonary disease(COPD) at stable stage, and investigate its clinical application value.MethodsSixty-six elderly patients with stable COPD were divided randomly into the control group and observation group(33 cases in each group).The control group was treated with conventional therapy, and observation group was treated with conventional therapy combined with oral acetylcysteine for 2 months.The levels of PASP and RVEF were detected using echocardiography, and the serum levels of CRP and SOD were measured in two groups before and after 1 and 2 months of treatment.ResultsAfetr treatment, the levels of PASP and CRP in two groups decreased compared with before treatment, and the differences of the decreasing degree of levels of PASP and CRP between two groups after 2 months of treatment were statistically significant(P < 0.05 and P < 0.01).Afetr treatment, the levels of SOD in two groups increased compared with before treatment, and the difference of the increasing degree of level of SOD between two groups was statistically significant(P < 0.05 and P < 0.01).The differences of the increasing degree of RVEF between and within two groups were not statistically significant(P>0.05).ConclusionsThe combined use of acetylcysteine in the treatment of elderly patients with COPD at stable stage is beneficial to the control of pulmonary artery pressure by inhibiting inflammatory response and improving antioxidant capacity, which has clinical application value.