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Lancet Respir Med:乙酰半胱氨酸减少中国COPD患者的急性加重

2014-04-16 佚名 dxy

氧化应激和炎症在慢性阻塞性肺疾病(COPD)的发病机制中起一定作用,但具有抗氧化和抗炎性质的药物(如N-乙酰半胱氨酸)是否能为COPD患者提供有效治疗目前尚不清楚。 来自广州医科大学附属第一医院、广州呼吸疾病研究所的钟南山院士带领团队进行了一项研究,结果显示, N-乙酰半胱氨酸治疗可以减少我国中重度COPD患者的急性发作。文章发表在近期的The Lancet杂志上。 这是一项前瞻性、随机、双盲、平

氧化应激和炎症在慢性阻塞性肺疾病(COPD)的发病机制中起一定作用,但具有抗氧化和抗炎性质的药物(如N-乙酰半胱氨酸)是否能为COPD患者提供有效治疗目前尚不清楚。

来自广州医科大学附属第一医院、广州呼吸疾病研究所的钟南山院士带领团队进行了一项研究,结果显示, N-乙酰半胱氨酸治疗可以减少我国中重度COPD患者的急性发作。文章发表在近期的The Lancet杂志上。

这是一项前瞻性、随机、双盲、平行组别、安慰剂对照的临床试验。研究对象为中国34所医院的中重度COPD患者,年龄40-80岁,应用支气管扩张剂后的一秒钟用力呼气容积(FEV1)与用力肺活量比值<0.7,且实测FEV1为预测值的30%-70%。

根据患者在基线时是否常规使用吸入糖皮质激素对受试者进行分层,并随机分配接受1年N-乙酰半胱氨酸(600毫克片剂,每日两次),或匹配的安慰剂治疗。主要研究终点是随机分组后至少接受一剂研究药物和一次随访评估的患者年度急性加重率。

在2009年6月25日-2010年12月29日期间,筛选的1297例患者中,有1006例符合随机分组条件,其中随机到N-乙酰半胱氨酸组和安慰剂组者分别为504例和502例。

1年后,2组患者中至少接受一剂研究药物和一次随访评估的例数均为482例,出现急性加重的例数分别为497例(1.16次/病人年)和641例(1.49次/病人年);2组间的危险比为0.78。

受试者对N-乙酰半胱氨酸的耐受性良好。495例至少接受一个剂量N-乙酰半胱氨酸的患者中,146例(29%)报告有不良事件,其中48例为严重事件;而495例至少接受一剂安慰剂患者的上述数字则分别为130例(26%)和46例。

最常见的严重不良事件是COPD急性加重,其在N-乙酰半胱氨酸组和安慰剂组患者中的发生率分别为32/495例(6%)和36/495例(7%)。

研究结果表明,对于我国的中重度COPD患者而言,N-乙酰半胱氨酸600毫克,每日两次长期治疗,可以预防其病情急性加重,这在中度疾病患者中更为明显。未来研究仍需探讨N-乙酰半胱氨酸对轻度COPD患者的疗效。

原始出处

Zheng JP1, Wen FQ2, Bai CX3, Wan HY4, Kang J5, Chen P6, Yao WZ7, Ma LJ8, Li X9, Raiteri L10, Sardina M10, Gao Y1, Wang BS11, Zhong NS12; PANTHEON study group.Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial.Lancet Respir Med. 2014 Mar

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    2018-03-06 owlhealth

    不错耶.学习了

    0

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    2014-10-03 howi
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    2014-04-18 gous
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    2014-04-17 gongzuozhong

    恩,这个题目更好

    0

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    2014-04-16 xiongyl1207

    N-乙酰半胱氨酸减少COPD患者的急性加重期

    0

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