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Efficacy of Acetylcysteine Inhalation Combined with Tiotropium Inhalation in the Treatment of Acute Exacerbation of COPD and Its Influence on Oxidative Stress Factors and Inflammatory Factors |
KUANG Xiangdong, CAI linzai, XIE Jingchen, et al |
Hainan Western Central Hospital, Hainan Danzhou 571799, China |
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Abstract Objective: To explore the effect of acetylcysteine inhalation combined with tiotropium inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) and its influence on oxidative stress factors and inflammatory factors. Methods: A total of 163 patients with acute exacerbation of COPD between January 2019 and January 2021 were enrolled as the research subjects, and they were divided into two groups based on nonrandomized clinical concurrent control study. Among them, 92 cases in the observation group were administered acetylcysteine inhalation combined with tiotropium inhalation, and 71 cases in the control group were treated with tiotropium inhalation. The clinical efficacy after 2 weeks’ treatment, as well as lung function [forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), expiratory flow rate at 50% vital capacity (PEF50), total lung capacity (TLC)], arterial blood gas indexes [oxygen saturation (SaO2), partial pressure of blood oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), PH], serum oxidative stress indicators [malondialdehyde (MDA),superoxide dismutase (SOD), nitric oxide (NO)] and inflammatory factors [procalcitonin (PCT),hypersensitive C-reactive protein (hs-CRP)] before treatment and after 2 weeks’ treatment were compared between the two groups. Results: After 2 weeks’ treatment, the total clinical effective rate of observation group was higher than that of control group (P<0.05). The FEV1, PEF, PEF50 and TLC of the two groups were improved compared with those before treatment, and the changes of observation group were greater than those of control group (P<0.05). The SaO2, PaO2 and PH of the two groups were increased while the PaCO2 was decreased compared to before treatment, and the changes were greater in observation group compared to control group (P<0.05). The level of serum SOD of the two groups was higher than that before treatment while the levels of MDA and NO were lower than those before treatment, and the changes of observation group were greater compared with those of control group (P<0.05). The levels of serum hs-CRP and PCT in the two groups were lower than those before treatment, and the changes were greater in observation group than those in control group (P<0.05). Conclusion: Acetylcysteine inhalation combined with tiotropium inhalation in the treatment of acute exacerbation of COPD can enhance the efficacy, with anti-inflammatory and antioxidant effects.
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