The Observation Of Curative Effect Of Acetylcysteine Alveolar Lavage In Chronic Obstructive Pulmonary Disease

Objective:Explorer the clinical efficacy of acetylcysteine（AC）alveolar lavage for acute exacerbation of chronic obstructive pulmonary disease（AECOPD）,provides a new approach to treating COPD in the middle and old patients,and to improve the prognosis,reduce the cost,improve the quality of life of patients.Methods:Patients admitted to department of Respiratory and Critical Care of Xian Central Hospital from January 1,2022 to March 1,2023 because of"AECOPD",patients who had satisfied the criteria for inclusion in the control group and the observation group,were randomly assigned to the group.In the control group（BAL group）,routine COPD therapy was combined with saline bronchoalveolar lavage;the observation group（AC+BAL group）was given conventional COPD treatment combined with acetylcysteine??bronchoalveolar lavage.The white blood cells（WBC）,proportion of neutrophils（NEU%）,proportion of eosinophils（EOS%）,C-reactive protein（CRP）,procalcitonin（PCT）and partial pressure of oxygen in arterial blood（Pa O₂）were checked in the control group and observation group before bronchoalveolar lavage,After treatment,the examination of blood routine,procalcitonin and arterial blood gas analysis were observed,and WBC count,neutrophil percent,eosinophil percent,C-reactive protein,procalcitonin,arterial partial pressure of oxygen were compared in both groups,and statistics were processed with SPSS 26.0 statistical software.Results:To compare the WBC,NEU%,CRP,PCT,EOS%and arterial oxygen partial pressure between the two groups.The results of this study show that:before and after treatment in the observation group,there were statistical differences in the total number of white blood cells（t=4.397,p=0.000）,percentage of neutrophils（t=5.572,p=0.000）,C-reactive protein（t=3.462,p=0.002）,arterial partial pressure of oxygen（t=-6.967,p=0.000）;there was no significant difference in the level of procalcitonin（t=1.387,p=0.179）and the percentage of eosinophils（t=-0.925,p=0.365）.In the control group,before and after treatment the total number of white blood cells（t=0.383,p=0.705）,neutrophil percentage（t=0.641,p=0.528）,eosinophil percentage（t=0.587,p=0.563）,C-reactive protein（t=1.709,p=0.292）,procalcitonin（t=1.011,p=0.323）,partial pressure of blood oxygen（t=0.362,p=0.721）was no statistical difference.Before bronchoalveolar lavage,there were no significant differences in the total number of white blood cells（t=0.880,p=0.386）,percentage of neutrophils（t=1.552,p=0.129）,percentage of eosinophils（t=-1.836,p=0.077）,C-reactive protein（t=1.279,p=0.201）,procalcitonin（t=1.586,p=0.126）and arterial partial pressure of oxygen（t=-1.582,p=0.121）between the observation group and the control group;after treatment,there were significant differences in the total number of white blood cells（t=-2.272,p=0.028）,percentage of neutrophils（t=-2.682,p=0.010）and the arterial partial pressure of oxygen（t=2.868,p=0.006）,there were no significant differences in eosinophil percentage（t=-1.556,p=0.127）,C-reactive protein（t=-0.379,p=0.706）and procalcitonin（t=0.719,p=0.467）.Conclusion:From the above results,it is inferred that acetylcysteine alveolar lavage has an adjuvant therapeutic effect for patients with acute exacerbation of COPD:1.Simple alveolar lavage did not significantly improve the inflammatory factors and arterial oxygen partial pressure in patients with acute exacerbation of chronic obstructive pulmonary disease;2.Acetylcysteine alveolar lavage can reduce the inflammatory indexes and improve the arterial oxygen partial pressure of patients with acute exacerbation of chronic obstructive pulmonary disease,the effect is better than that of simple alveolar lavage.