Effects of acetylcysteine tablets combined with methylprednisolone on blood gas indexes, pulmonary function and serum inflammatory factors in patients with idiopathic interstitial pneumonia

doi:10.3877/cma.j.issn.1674-6902.2019.06.014

Abstract

Abstract:

Objective

To analyze the effects of acetylcysteine tablets combined with methylprednisolone on blood gas indexes, pulmonary function and serum inflammatory factors in the patients with idiopathic interstitial pneumonia (IIP).

Methods

A total of 80 patients with IIP who were admitted to the Department of Respiratory and Critical Care Medicine, Yichang Central People′s Hospital, were randomly divided into an observation group (n=42) and a control group (n=38). The control group received routine symptomatic treatment and anti-inflammatory treatment with methylprednisolone. On this basis, the observation group received an additional treatment of acetylcysteine tablets. At two weeks after treatment, the clinical curative effect, the blood gas indexes [the arterial partial pressure of oxygen (PaO₂) and the arterial partial pressure of carbon dioxide (PaCO₂)], the lung functions [the forced vital capacity (FVC), the ratio of diffusing capacity of carbonic oxide and the alveolar volume (DLCO/VA), and the percentage of forced expiratory volume in one second in the predicted value (FEV₁%)], the levels of serum transforming growth factor-β (TGF-β), the vascular endothelial growth factor (VEGF), and the high-sensitivity C-reactive protein (hs-CRP), and the adverse reactions were observed.

Results

The effective rate of the observation group was significantly higher than that of the control group (85.00% vs. 65.00%, P<0.05). The PaO₂ was increased in both groups after 1 week and 2 weeks of treatment, while the PaCO₂ was decreased. The PaO₂ was higher in the observation group than the control group after 1 week and 2 weeks of treatment, while the PaCO₂ was lower in the observation group than the control group (P<0.05). The FVC, DLCO/VA and FEV₁% were higher in the observation group than the control group (P<0.05). After treatment, the levels of serum TGF-β, VEGF and hs-CRP in the observation group were significantly lower than those of the control group (P<0.01). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion

The curative effect of acetylcysteine tablets combined with methylprednisolone is better than that of methylprednisolone alone on IIP, which can significantly improve the blood gas indexes and the pulmonary function and inhibit pulmonary fibrosis.

Key words: Acetylcysteine tablets, Methylprednisolone, Idiopathic interstitial pneumonia, Blood gas analysis, Pulmonary function, HRCT

Lu Cao, Baoan Gao, Li Guan, Shixiong Chen. Effects of acetylcysteine tablets combined with methylprednisolone on blood gas indexes, pulmonary function and serum inflammatory factors in patients with idiopathic interstitial pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(06): 738-742.

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References 18

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组　别		例数	治疗前	治疗1周	治疗2周	F值	P值
PaO₂(mmHg)
	观察组	42	43.57±4.48	54.12±5.61^a	70.64±7.18^a	261.693	<0.001
	对照组	38	44.01±4.46	48.69±4.92^a	60.59±6.13^a	107.355	<0.001
	t值		0.440	4.602	6.733
	P值		0.661	0.000	0.000
组　别		例数	治疗前	治疗1周	治疗2周	F值	P值
PaCO₂(mmHg)
	观察组	42	41.26±4.28	37.10±3.85^a	34.45±3.52^a	31.057	<0.001
	对照组	38	41.54±4.23	39.06±4.10^a	37.19±3.86^a	11.520	<0.001
	t值		0.294	2.204	3.317
	P值		0.769	0.030	0.001

组　别		例数	治疗前	治疗1周	治疗2周	F值	P值
PaO₂(mmHg)
	观察组	42	43.57±4.48	54.12±5.61^a	70.64±7.18^a	261.693	<0.001
	对照组	38	44.01±4.46	48.69±4.92^a	60.59±6.13^a	107.355	<0.001
	t值		0.440	4.602	6.733
	P值		0.661	0.000	0.000
组　别		例数	治疗前	治疗1周	治疗2周	F值	P值
PaCO₂(mmHg)
	观察组	42	41.26±4.28	37.10±3.85^a	34.45±3.52^a	31.057	<0.001
	对照组	38	41.54±4.23	39.06±4.10^a	37.19±3.86^a	11.520	<0.001
	t值		0.294	2.204	3.317
	P值		0.769	0.030	0.001

组　别	例数	FVC(L)		DLCO/VA(%)		FEV₁%(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	42	60.45±6.18	76.20±7.71^a	62.48±6.35	70.41±7.10^a	64.25±6.80	70.67±7.15^a
对照组	38	60.29±6.23	65.32±6.68^a	61.96±6.48	64.99±6.37^a	64.19±6.85	67.49±6.83^a
t值		0.115	6.745	0.362	3.594	0.039	2.034
P值		0.908	0.000	0.718	0.000	0.969	0.045

组　别	例数	FVC(L)		DLCO/VA(%)		FEV₁%(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	42	60.45±6.18	76.20±7.71^a	62.48±6.35	70.41±7.10^a	64.25±6.80	70.67±7.15^a
对照组	38	60.29±6.23	65.32±6.68^a	61.96±6.48	64.99±6.37^a	64.19±6.85	67.49±6.83^a
t值		0.115	6.745	0.362	3.594	0.039	2.034
P值		0.908	0.000	0.718	0.000	0.969	0.045

组　别	例数	TGF-β(ng/L)		VEGF(ng/L)		hs-CRP(mg/L)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	42	0.54±0.06	0.34±0.05^a	420.59±43.11	276.54±28.59^a	7.03±0.73	2.87±0.31^a
对照组	38	0.53±0.05	0.42±0.06^a	421.65±42.87	317.44±32.68^a	6.95±0.71	4.10±0.46^a
t值		0.810	6.478	0.110	5.957	0.497	14.024
P值		0.420	0.000	0.912	0.000	0.621	0.000

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