乙酰半胱氨酸雾化联合双水平气道正压通气治疗急性呼吸窘迫综合征患者的临床疗效

doi:10.3969/j.issn.1671-7171.2026.07.010

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摘要 【目的】探讨乙酰半胱氨酸雾化联合双水平气道正压通气(BiPAP)治疗急性呼吸窘迫综合征(ARDS)的临床疗效。【方法】选取2020年1月至2024年7月本院收治的80例ARDS患者,按治疗方法不同分为观察组(n=41)和对照组(n=39)。对照组采用BiPAP治疗,观察组在对照组基础上加用乙酰半胱氨酸雾化治疗,比较两组治疗效果。【结果】观察组总有效率显著高于对照组(P＜0.05)。治疗14 d后,观察组动脉血氧分压(PaO₂)、超氧化物歧化酶(SOD)水平高于对照组,丙二醛(MDA)、动脉血二氧化碳分压(PaCO₂)、吸入氧浓度(FiO₂)低于对照组(P＜0.05)。治疗14 d后,观察组第1秒用力呼气容积(FEV₁)、最大自主通气量(MMV)、FEV₁/用力肺活量(FEV₁/FVC)高于对照组(P＜0.05)。治疗14 d后,观察组CD4⁺、CD4⁺/CD8⁺高于对照组,CD8⁺低于对照组(P＜0.05)。两组不良反应总发生率比较,差异无统计学意义(P＞0.05)。【结论】采用乙酰半胱氨酸雾化联合BiPAP治疗ARDS患者,可改善患者肺功能,提升免疫功能,且不会增加不良反应的发生。

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	刘秋红
	李晨
	梁夏存
	周金桥

关键词 ：呼吸窘迫综合征, 急性病, 乙酰半胱氨酸, 投药,吸入, 连续气道正压通气

Abstract：【Objective】 To investigate the clinical efficacy of nebulized acetylcysteine combined with bi-level positive airway pressure (BiPAP) ventilation in the treatment of patients with acute respiratory distress syndrome (ARDS). 【Methods】 A total of 80 ARDS patients admitted to our hospital from January 2020 to July 2024 were enrolled and divided into the observation group (n=41) and the control group (n=39) according to different therapeutic regimens. The control group received BiPAP ventilation alone, while the observation group was given additional nebulized acetylcysteine on the basis of BiPAP treatment. The therapeutic effects of the two groups were compared. 【Results】 The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After 14 days of treatment, the levels of arterial partial pressure of oxygen (PaO₂) and superoxide dismutase (SOD) in the observation group were higher, while malondialdehyde (MDA), arterial partial pressure of carbon dioxide (PaCO₂) and fraction of inspired oxygen (FiO₂) were lower than those of the control group (P<0.05). After 14 days of treatment, forced expiratory volume in the first second (FEV₁), maximal voluntary ventilation (MMV) and FEV₁/forced vital capacity (FEV₁/FVC) of the observation group were superior to the control group (P<0.05). The levels of CD4⁺ and CD4⁺/CD8⁺ in the observation group were higher, and CD8⁺ was lower than the control group after 14 days (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). 【Conclusions】 Nebulized acetylcysteine combined with BiPAP ventilation can improve pulmonary function and immune function in ARDS patients without increasing the risk of adverse reactions.

Key words： Respiratory Distress Syndrome Acute Disease Acetylcysteine Administration,Inhalation Continuous Positive Airway Pressure

收稿日期: 2025-10-27

中图分类号:

R563.8

基金资助:河南省医学科技攻关计划项目(编号:SBGJ202102172)

引用本文:

刘秋红, 李晨, 梁夏存, 周金桥. 乙酰半胱氨酸雾化联合双水平气道正压通气治疗急性呼吸窘迫综合征患者的临床疗效[J]. 医学临床研究, 2026, 43(7): 1090-1093.
LIU Qiuhong, LI Chen, LIANG Xiacun, ZHOU Jinqiao. Clinical Efficacy of Nebulized Acetylcysteine Combined with Bi-Level Positive Airway Pressure Ventilation in Patients with Acute Respiratory Distress Syndrome. JOURNAL OF CLINICAL RESEARCH, 2026, 43(7): 1090-1093.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.07.010 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I7/1090

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