[1]魏胜全,薛 华,王惠霞,等.罗红霉素联合N-乙酰半胱氨酸治疗慢性阻塞性肺疾病合并肺间质纤维化疗效及对患者肺功能的影响[J].陕西医学杂志,2020,49(5):611-614.
　WEI Shengquan,XUE Hua,WANG Huixia,et al.Curative effect of roxithromycin combined with N-acetylcysteine in treatment of COPD and pulmonary interstitial fibrosis and the influence on pulmonary function[J].,2020,49(5):611-614.
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罗红霉素联合N-乙酰半胱氨酸治疗慢性阻塞性肺疾病合并肺间质纤维化疗效及对患者肺功能的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
611-614
栏目:
药物与临床
出版日期:
2020-05-05

文章信息/Info

Title:
Curative effect of roxithromycin combined with N-acetylcysteine in treatment of COPD and pulmonary interstitial fibrosis and the influence on pulmonary function
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.027
作者:
魏胜全1; 薛 华2; 王惠霞1; 贾汝臻1
1.陕西省宝鸡市人民医院(宝鸡 721000); 2.陕西省咸阳市人民医院(咸阳 712000)
Author(s):
WEI Shengquan; XUE Hua; WANG Huixia; et al.
Baoji People's Hospital,Shaanxi Province(Baoji 721000)
关键词:
慢性阻塞性肺病;  肺间质纤维化;  治疗;  罗红霉素;  N-乙酰半胱氨酸;  肺功能
Keywords:
Chronic obstructive pulmonary disease;  Pulmonary interstitial fibrosis;  Therapy;  Roxithromycin;  N-acetylcysteine;  Pulmonary function
分类号:
R569.3
文献标志码:
A
摘要:
目的:探讨使用罗红霉素联合N-乙酰半胱氨酸(NAC)治疗慢性阻塞性肺疾病合并肺间质纤维化(COPD-PIF)的临床效果。方法:选取COPD-PIF患者82例,随机分为对照组和联合组,对照组在COPD常规治疗基础上给予大剂量(1.2 g/d)NAC治疗,联合组在对照组基础上加用小剂量(150 mg/d)罗红霉素治疗,两组均治疗90 d。比较两组治疗前后肺功能指标[第一秒用力呼气容积占预计值百分比(FEV1%)、用力肺活量占预计值百分比(FVC%)、一氧化碳弥散量占预计值百分比(DLCO%)],动脉血氧分压(PaO2),慢性阻塞性肺病评估测试(CAT)评分,急性加重次数,血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,临床疗效以及不良反应情况。结果:联合组总有效率(80.95%)显著高于对照组(55.00%)(P<0.05); 两组FEV1%、FVC%和DLCO%均较治疗前明显提高,且联合组显著高于对照组(P<0.05); 两组PaO2明显均高于治疗前,且联合组显著高于对照组(P<0.05); 两组CAT评分、急性加重次数均较治疗前明显下降,且联合组显著低于对照组(P<0.05); 两组TNF-α、IL-6水平均较治疗前明显下降,且联合组显著低于对照组(P<0.05); 联合组总不良反应发生率(19.05%)与对照组(12.50%)比较无统计学差异(P>0.05)。结论:小剂量罗红霉素联合NAC治疗COPD-PIF患者能有效提升疗效,改善肺功能、提高PaO2、降低CAT评分,并且能降低促炎细胞因子水平,减少急性加重次数,未明显增加不良反应。
Abstract:
Objective:To investigate clinical curative effect of roxithromycin combined with N-acetylcysteine(NAC)in treatment of chronic obstructive pulmonary disease and pulmonary interstitial fibrosis(COPD-PIF). Methods:Eighty-two patients with COPD-PIF were enrolled and randomly divided into control group and combination group. The control group was treated with large-dose(1.2 g/d)NAC on basis of routine COPD treatment,while the combination group was treated with small-dose(150 mg/d)roxithromycin on basis of control group. Both groups were treated for 90 days. Pulmonary function indexes [forced expiratory volume in one second as a percentage of predicted value(FEV1%),forced vital capacity as a percentage of predicted value(FVC%),carbon monoxide diffusion capacity as a percentage of predicted value(DLCO%)],arterial partial pressure of oxygen(PaO2),score of COPD assessment test(CAT),times of acute exacerbation,levels of serum TNF-α and IL-6,clinical curative effect and adverse reactions before and after treatment were compared between the two groups. Results:The total response rate in combination group was significantly higher than that in control group(80.95% vs. 55.00%)(P<0.05). After treatment,FEV1%,FVC% and DLCO% in both groups were significantly increased,which were significantly higher in combination group than control group(P<0.05). After treatment,PaO2 in both groups was significantly increased,which was significantly higher in combination group than control group(P<0.05). After treatment,CAT scores and times of acute exacerbation in both groups were significantly decreased,which were significantly lower in combination group than control group(P<0.05). After treatment,the levels of serum TNF-α and IL-6 in both groups were significantly decreased,which were significantly lower in combination group than control group(P<0.05). There was no significant difference in total incidence of adverse reactions between combination group and control group(19.05% vs. 12.50%)(P>0.05). Conclusion:Low-dose roxithromycin combined with NAC can effectively improve curative effect on COPD-PIF patients,and improve pulmonary function,increase PaO2,reduce CAT scores,reduce levels of proinflammatory cytokines,and decrease times of acute exacerbation,without significant increasing adverse reactions.

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更新日期/Last Update: 2020-07-28