大剂量N-乙酰半胱氨酸(NAC)对治疗中、重度慢性阻塞性肺疾病有效性的研究

目的探讨大剂量N-乙酰半胱氨酸治疗中、重度慢性阻塞性肺疾病相对于安慰剂的有效性。方法采用便利抽样的原则抽取某市三级甲等医院呼吸科门诊就诊的中、重度慢性阻塞性肺疾病患者60例,按照随机双盲对照的原则将患者分为N-乙酰半胱氨酸组和安慰剂组,对患者进行随访6个月,比较两组患者治疗前后肺功能和生活质量（St.George问卷评分）变化。结果 N-乙酰半胱氨酸组治疗前后,肺功能指标FVC%、FEV1%,FEV1/FVC,P〉0.05,无显著差异。安慰剂组治疗前后FVC%、FEV1%,FEV1/FVC,P〈0.01,有显著性差异。两组治疗后肺功能指标中FVC%,FEV1/FCV（L）FEV1%P〈0.05,差异有显著性。N-乙酰半胱氨酸组患者治疗前后SGRQ问卷的呼吸症状评分、活动受限评分、疾病影响评分、总分值,P〈0.01,有显著性差异。安慰剂组治疗前后各部分生存质量评分P〉0.05无显著差异。两组治疗后呼吸症状评分P〉0.05无显著差异,活动受限评分、疾病影响评分、总分值,P〈0.05,差异有显著性。结论大剂量N-乙酰半胱氨酸（NAC）可以稳定中重度COPD患者肺功能,延缓肺功能进行性下降,提高中重度COPD患者的生活质量。

The effects of N-acetylcysteine high dose on lung function and the quality of life in patients with chronic obstructive pulmonary disease

[ Objective ] To investigate piacebo-cintrolled study 1200mg on lung function and the quality of life in patients suffering from moderate to severe chronic obstructive pulmonary disease（COPD）. [ Methods ] The menthod ofpatients selected was used by convenience sampling.60 selected patients are groups according to the principle of doubleblind controlled study,patients received the same opportunities for access to N-acetylcysteine or placebo-controlled group.After discharge, the patients received the follow-up intervention for six months, compared lung function and the patient＇s quality of life （St George＇s Respiratory Questionnaire ）before and after the intervention. [ Resluts ] N-acetylcysteine group,the level of FVC%, FEVI%, FEV1/FVC, after treatment were no significant difference compared with that at the beginning of treatment （P〉 0.05）..In the placebo-controlled group, the level of FVC%, FEV1%, FEV1/FVC, after treatment weredecreased compared with that at the beginning of treatment （P 〈0.01）.After treatment two groups, lung function indicators in FVC%, FEV1/FCV （L）, FEVI%, compared with before treatment, the effect between two groups has significantdifference （P 〈0.05）.SGRQ questionnaires of the respiratory symptom scores, the limitation of activity score, the disease impact score, the total score, after treatment were decreased compared with that at the beginning of treatment （P 〈0.01）.In the Placebo-controlled group, SGRQ questionnaires of the respiratory symptom scores, the limitation of activity score, the disease impact score, total score, after treatment were no significant difference compared with that at the beginningof treatment.After treatment two groups, SGRQ questionnaires of the respiratory symptom scores, after treatment were no significant difference（P〉 0.05）, the limitation of activity score, the disease impact score, the total score, after treatmentwere significant difference compared with that at the beginning of treatment（P〈0.05）. [ Conclusion ] N-acetylcysteine has delaying lung function decline and improve the quality of life suffering from moderate to severe COPI）.