吉林大学学报(医学版)

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沙美特罗/丙酸氟替卡松联合N-乙酰半胱氨酸治疗慢性阻塞性肺疾病的疗效评价

徐晓光1，姜振宇2，杜敏娟3，杨亚琴1，蒋颖超1   

  1. 1.吉化集团公司总医院呼吸内科，吉林 吉林 132021；2.吉林大学第一医院风湿免疫科，吉林 长春 130021；3.吉林医药学院附属医院肿瘤科，吉林 吉林 132001
  • 收稿日期:2014-01-28 出版日期:2014-07-28 发布日期:2015-01-18
  • 通讯作者: 姜振宇（Tel：0431-88782060，E-mail：512517403@qq.com） E-mail:512517403@qq.com
  • 作者简介:徐晓光（1980-），男，辽宁省朝阳市人，主治医师，医学硕士，主要从事慢性阻塞性肺疾病及哮喘的基础与临床研究。
  • 基金资助:

    吉林省科技厅科研基金资助课题（20090454）

Evaluation on effectiveness of salmeterol/fluticasonepropionate combined with N-acetylcysteine in treatment of   chronic obstructive pulmonary disease

XU Xiao-guang1，JIANG Zhen-yu2，DU Min-juan3，YANG Ya-qin1，JIANG Ying-chao1   

  1. 1.Department of Respiratory Medicine， General Hospital，Jilin Chemical Group Corporation，Jilin 132021，China；2.Department of Rheumatology，First Hospital，Jilin University，Changchun 130021，China；3.Department of Oncology，Affiliated Hospital，Jilin Medical College，Jilin 132001，China
  • Received:2014-01-28 Online:2014-07-28 Published:2015-01-18

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摘要：

目的：探讨沙美特罗/丙酸氟替卡松联合N-乙酰半胱氨酸对慢性阻塞性肺疾病（COPD）患者肺功能及动脉血气分析指标的影响并评价其疗效。方法：将84例COPD患者随机分为联合治疗组（44例）和单纯治疗组（40例）。联合治疗组应用沙美特罗/丙酸氟替卡松联合N乙酰半胱氨酸治疗，单纯治疗组应用沙美特罗/丙酸氟替卡松治疗，均随访6个月。分别记录2组患者用药前和用药3及6个月后肺功能指标：包括第1秒用力肺活量占用力肺活量的百分比（FEV1%FVC），第1秒用力肺活量占预计值的百分比（FEV1% Pred）和呼气峰流速（PEF）日变异率（ΔPEF%）；记录动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）的变化。结果：与治疗前比较，治疗3和6个月后联合治疗组和单纯治疗组患者的FEV1%FVC、FEV1%Pred和PaO2均明显升高(P<0.01)，PaCO2均明显下降（P<0.01）；联合治疗组与同期单纯治疗组比较
上述指标变化更显著，差异均有统计学意义（P<0.05）。2组患者治疗3和6个月后上述指标组内比较差异均无统计学意义（P>0.05），2组患者ΔPEF%治疗前后组内及组间比较差异均无统计学意义（P>0.05）。结论：沙美特罗/丙酸氟替卡松和N-乙酰半胱氨酸联合使用可明显改善COPD患者肺功能及动脉血气分析指标，治疗COPD疗效确切而持久。

关键词: 沙美特罗/丙酸氟替卡松, N-乙酰半胱氨酸, 慢性阻塞性肺疾病, 肺功能, 血气分析

Abstract:

Objective To explore the effects of salmeterol/fluticasone propionate complicated or combined with N-acetylcysteine on the pulmonary function and  arterial blood gas analysis of the patients with chronic obstructive pulmonary disease(COPD)，and to evaluate its curative effect.Methods 84 cases of COPD patients were randomly divided into combination treatment group (n=44) and simple treatment group (n=40).The patients in combination treatment group were treated with
salmeterol/fluticasone propionate combinated with N-acetylcysteine while the patients in simple treatment group were treated only with salmeterol/fluticasone prop
ionate，both of which were followed up for 6 months.The changes of pulmonary function (FEV1%FVC,FEV1%Pred,PEF daily variation rate: Δ PEF%) and  theart
erial blood gas analysis indexes ( PaO2 and PaCO2 ) of the patients in two groups were recorded before treatment,3 months after treatment,and 6 months after treatment.Results The FEV1%FVC,FEV1%Pred and PaO2 of the patients in combinationtreatment group and simple treatment group were obviously increased 3 and 6 months after treatment compared with before treatment (P<0.01)，and the PaCO2 were obviously decreased (P<0.01).And there were significant differences of the indexes mentioned above of the patients  between two groups(P<0.05)；but the indexes of each group had no significant differences between 3 months and 6 months after treatment(P>0.05).The Δ PEF% of the patients in two groups had no significant differences between inter-group and intra-group before and after treatment (P>0.05).Conclusion Combination of salmeterol/fluticasone propionate and N-acetylcysteine can obviously improve the pulmonary function and arterial blood gas analysis indexes  of the COPD patients,which is superior to the simple application of salmeterol/fluticasone propionate and has definite and lasting curative effect on the treatment of COPD.
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Key words: salmeterol/fluticasone propionate, N-acetylcysteine, chronic obstructive pulmonary disease, pulmonary function test, blood gas analysis

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