目的 探討乙酰半胱氨酸顆粒聯(lián)合莫西沙星治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床效果。方法 選取2017年6月—2020年6月天津市第五中心醫(yī)院（北京大學(xué)濱海醫(yī)院）收治的86例AECOPD患者，使用隨機(jī)數(shù)字表法分成對照組（n=43）和治療組（n=43）。對照組靜脈滴注鹽酸莫西沙星注射液，每次將0.4 g加入5%葡萄糖注射液250 mL中充分稀釋后給藥，1次/d。治療組在對照組基礎(chǔ)上口服乙酰半胱氨酸顆粒，1包/次，3次/d。兩組均連續(xù)治療14 d。觀察兩組臨床療效及患者典型呼吸道癥狀和體征的緩解時(shí)間。并比較治療前后兩組血清白三烯B4（LTB4）、白細(xì)胞介素-8（IL-8）、8異前列腺素F2α（8-iso-PGF2α）、前白蛋白（PA）、丙二醛（MDA）水平。結(jié)果 治療后，治療組總有效率為95.3%，顯著高于對照組79.1%（P<0.05）。治療后，治療組咳嗽、咳痰、喘息和肺部哮鳴音緩解時(shí)間均顯著短于對照組（P<0.05）。治療后，兩組血清LTB4、IL-8、8-iso-PGF2α及MDA水平均較本組治療前顯著下降（P<0.05），血清PA水平則均顯著升高（P<0.05）；且治療后，治療組血清學(xué)指標(biāo)改善優(yōu)于對照組（P<0.05）。結(jié)論 乙酰半胱氨酸顆粒聯(lián)合莫西沙星對AECOPD患者具有確切的臨床療效，能安全有效且迅速地穩(wěn)定患者病情，改善肺功能，并可顯著減輕機(jī)體炎癥反應(yīng)、降低氧化應(yīng)激損傷，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Acetylcysteine Granules combined with moxifloxacin in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 86 AECOPD patients admitted to Tianjin Fifth Central Hospital (Peking University Binhai Hospital) from June 2017 to June 2020 were randomly divided into control group (n=43) and treatment group (n=43) by random number table method. Patients in the treatment group were iv administered with Moxifloxacin Hydrochloride and Sodium Chloride Injection, 0.4 g was added into 5% Glucose Injection 250 mL each time and fully diluted, once daily. Patients in the treatment group were po administered with Acetylcysteine Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy and relief time of typical respiratory symptoms and signs were observed. Serum levels of LTB4, IL-8, 8-iso-PGF2α, PA, and MDA were compared between the two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 95.3%, significantly higher than 79.1% of control group (P < 0.05). After treatment, the relief time of cough, expectoration, wheezing and pulmonary wheezing in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the levels of LTB4, IL-8, 8-iso-PGF2α, and MDA in two groups were significantly decreased compared with before treatment (P < 0.05), but the level of serum PA was significantly increased (P < 0.05). After treatment, the serological index of the treatment group was better than that of the control group (P < 0.05). Conclusion Acetylcysteine Granules combined with moxifloxacin has a definite clinical effect on AECOPD patients, and can safely, effectively and rapidly stabilize patients' condition, can improve lung function, and also can significantly reduce inflammatory response and oxidative stress injury, which is worthy of clinical application.

R974