N-乙酰半胱氨酸对慢性阻塞性肺疾病急性加重期作用的Meta分析

目的评价在常规治疗基础上加用N-乙酰半胱氨酸(NAC)对改善慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床症状及肺功能的作用。方法计算机检索Cochrane图书馆、Pub Med、EMbase、EBSCO host、中国知网和万方学术会议论文中关于在常规治疗基础上加用NAC治疗AECOPD中应用的随机对照试验(RCTs),检索时间为2000年1月至2015年4月。按照纳入与排除标准选择文献、评价文献质量,而后采用Rev Man 5.30软件进行Meta分析。结果共纳入8篇RCT,其中有7个研究表明NAC可以显著提高AECOPD的症状改善率(RR=1.21,95%CI:1.08~1.36,P=0.001);有6个研究表明可以提高肺功能的第一秒钟用力呼气容积水平(WMD=0.33,95%CI:0.19~0.48,P0.01);有3个研究表明可以提高患者肺功能的最大肺活量水平(WMD=0.42,95%CI:0.29~0.54,P0.01);有4个研究表明可以提高患者动脉的血氧分压(WMD=7.30,95%CI:6.11~8.48,P0.01)。结论 N-乙酰半胱氨酸治疗后可提高AECOPD患者的临床症状改善率,改善患者的第一秒用力呼气量和最大肺活量水平,增加动脉血氧分压。

Effects of N-acetylcysteine on AECOPD:a systematic review of Meta analysis

Objective In order to further understand the effects of conventional treatment combined with N-acetylcysteine (NAC) in AECOPD on the clinical symptoms and the values of FEV₁ and FVC lung function.Methods The Cochrane library,PubMed,EMbase,EBSCO host,CNKI and Wanfang Data from January of 2000 to April of 2015 were searched to collect RCTs of conventional treatment combined with N-acetylcysteine in AECOPD.According to the inclusion and exclusion criteria,the quality of literature was evaluated,then the RevMan 5.30 software was used for Meta analysis for the standard RCTs.Results A total of eight RCTs were included,and seven studies showed that NAC could significantly increase the improvement rate (RR=1.21,5%CI:1.08-1.36,P=0.01).Six RCTs indicated that NAC could improve the FEV₁ level of lung function (WMD=0.33,5%CI:0.19-0.48,P<0.01).Three RCTs showed that NAC could improve the FVC level of lung function (WMD=0.42,5%CI:0.29-0.54,P<0.01).Four RCTs showed that NAC could improve the patients of partial pressure of arterial oxygen (WMD=7.30,5%CI:6.11-8.48,P<0.01).Conclusion The conventional treatment combined with NAC can significantly improve the symptoms of AECOPD,FEV₁ level of lung function,FVC level of lung Function and partial pressure of arterial oxygen of the patients with AECOPD.