Effect Of N-acetylcysteine On Serum Biomarkers In Acute Exacerbations Of Chronic Obstructive Pulmonary Disease

Objective:Toinvestigatetheefficacyof NACinthetreatmentof AECOPDandits effectontheexpressionof SP-A,SP-D,CC16 anditssignificance.Method:Atotalof80AECOPDpatientswithgrade?and? wereenrolledfrom August2015 to May2016in Zhongshan Hospitalof Dalian University.Thepatients wererandomlydividedinto NACinterventiongroupandcontrolgroupwith40 casesineach.Thecontrolgroupwasgivenbasictreatment,whilethecontrolgroup wasgiventheadditional Nacetylcysteineonthebasisofthecontrolgroup.Thecourseoftreatmentwastwoweeks.Thelevelsof SP-A,SP-D and CC16 were measured by enzyme-linked immunosorbent assay(ELISA)before and after treatment,anditscorrelationbetweenlungfunctionand CATscores.Result:1.Thecomparisonsinthesamegroupsshowedthat,the CC16 inthe NAC interventiongroupwashigherthanthatbeforetreatment.SP-Dand SP-Awere lowerthanthosebeforetreatment;Thecomparisonsinthesamegroupsshowed that,the SP-Ainthecontrolgroupwaslowerthanthatbeforetreatment.Allofthe differenceshavestatisticalsignificance(P<0.05).Thecomparisonsbetweenthetwogroupsaftertreatmentshowedthat,the CC16 inthe NACinterventiongroupwashigherthanthatofthecontrolgroup.SP-D and SP-Awerelowerthanthoseinthecontrolgroup.Allofthedifferenceshave statisticalsignificance(P<0.05).2.The comparisons in the same groups showed that,the FEV1,FEV1%pre,FEV1/FVC(%)inthe NACinterventiongroupwerehigherthanthose before treatment;The comparisons in the same groups showed that,the FEV1/FVC(%)inthecontrolgroupwashigherthanthatbeforetreatment.Allofthe differenceshavestatisticalsignificance(P<0.05).Thecomparisonsbetweenthetwogroupsaftertreatmentshowedthat,the FEV1,FEV1/FVC(%)inthe NACinterventiongroupwerehigherthanthoseofthe controlgroup.Allofthedifferenceshavestatisticalsignificance(P<0.05).3.Thecomparisonsinthesamegroupsshowedthat,the CATscoresinthe NACinterventiongroupwerelowerthanthosebeforetreatment.Thecomparisons inthesamegroupsshowedthat,the CATscoresinthecontrolgroupwerelower than those before treatment.All of the differences have statistical significance(P<0.05).Thecomparisonsbetweenthetwogroupsaftertreatmentshowedthat,the CATscoresinthe NACinterventiongroupwerelowerthanthoseofthecontrol group.Allofthedifferenceshavestatisticalsignificance(P<0.05).4.Correlationbetweenserum biomarkers,pulmonaryfunctionand CATscores beforetreatment.SP-D wasnegativelycorrelated with FVE 1%preand FEV1/FVC(%),and was positively correlated with CAT scores;CCl6 was positively correlated with FEV1%preand FVE 1/FVC(%),andwasnegativelycorrelatedwith CATscores.There wasapositivecorrelationbetween SP-Aand FVE 1/FVC(%).Allofthedifferences havestatistical significance(P<0.05).Conclusion:1.The use of NAC can improve the levelof CC16,lung function,clinical symptoms,butreducesthelevelof SP-A,SP-Din AECOPDpatients.2.Thebiomarkers,lungfunctionand CATscoreswerecorrelated,suggesting thatbiomarkershaveacertainsignificanceonthediagnosisandevaluationof COPD.