阿奇霉素联合乙酰半胱氨酸对COPD稳定期患者肺功能与炎症因子影响

目的观察阿奇霉素联合乙酰半胱氨酸治疗慢性阻塞性肺疾病(COPD)稳定期患者肺功能及外周血TNF-α、IL-8、IL-18指标的变化。方法选择解放军第九二医院门诊收治的COPD稳定期患者120例为研究对象。将患者随机分为观察组和对照组,每组60例。对照组患者给予常规治疗,观察组在常规治疗基础上加阿奇霉素联合乙酰半胱氨酸口服,疗程18个月。在治疗前及治疗后6、12、18个月,检测两组肺功能及血清IL-8、IL-18、TNF-α水平的变化。结果治疗前及治疗后6、12个月,两组患者的FEV1%、FEV1/FVC%比较,差异均无统计学意义(P>0.05)。在治疗后18个月,观察组FEV1%、FEV1/FVC%较对照组明显升高(P<0.05)。治疗前及治疗后6个月,两组患者血清TNF-α、IL-8、IL-18水平比较,差异无统计学意义(P>0.05)。在治疗后12、18个月,观察组患者各项指标水平均明显低于对照组(P<0.05)。结论阿奇霉素联合乙酰半胱氨酸可抑制COPD患者炎症因子,具有调节免疫功能、抗氧化的作用,可延缓肺功能减退,在治疗COPD患者中具有一定临床实用价值。

Effect of Azithromycin combined with Acetylcysteine on serum cytokines in patients with stable COPD

Objective To investigate clinical effect of Azithromycin combined with Acetylcysteine on the patients with stable COPD. Methods Totally 120 patients with stable COPD were randomly divided into the observation group and the control group. The control group was treated with routine treatment,and the observation group was treated with Azithromycin combined with Acetylcysteine based on routine treatment. The levels of serum TNF-α,IL-8,IL-18 and lung function were detected before and 6,12 and 18 months after the treatment in the two groups. Results The levels of FEV1%,FEV1/FVC% showed no significant difference between the two groups before and after 6 and 12 months treatment(P>0. 05). And these were obviously higher in the observation group than in the control group 18 months after the treatment(P<0. 05). The levels of serum TNF-α,IL-8 and IL-18 showed no significant difference before and after 6 months treatment(P>0. 05),but these were obviously lower in the experiment group than in the control group at the time of 12 months and 18 months after the treatment(P<0. 05). Conclusion Azithromycin combined with Acetylcysteine can regulate im-mune function in COPD patients,relieve lung function deterioration,which have important clinical value in the treatment of chronic ob-structive pulmonary dieases.