Ghanei Mostafa, Shohrati Majid, Jafari Mehrdad, Ghaderi Soleyman, Alaeddini Farshid, Aslani Jafar
Research Center of Chemical Injuries, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Basic Clin Pharmacol Toxicol. 2008 Nov;103(5):428-32. doi: 10.1111/j.1742-7843.2008.00318.x. Epub 2008 Sep 17.
Administration of N-acetylcysteine may be effective in diseases caused by oxidative-antioxidative imbalance. We aimed to determine the effect administration for 4 months of N-acetylcysteine (1200 mg daily) on sulfur mustard-induced bronchiolitis obliterans in patients with normal pulmonary function test. In a double-blind clinical trial, 144 patients with bronchiolitis obliterans due to sulfur mustard and bronchiolitis obliterans syndrome class 0, randomly entered to group 1 (n = 72, N-acetylcysteine) and group 2 (n = 72, placebo). The changes in dyspnoea, wake-up dyspnoea, cough and sputum were measured after 4 months using a 'delta value' (i.e. symptom score after 4 months--symptom score before the trial). Spirometric findings were measured at the beginning of the trial, 2 months later and 4 months later. Dyspnoea (delta value: -0.78 (0.61), P < 0.001), wake-up dyspnoea (delta value: -0.57 (0.64), P < 0.001), and cough (delta value: -0.86 (0.63), P < 0.001) improved after 4 months of N-acetylcysteine administration compared to the control group. N-acetylcysteine reduced sputum from 76.9% (n = 40) of cases before the trial to 9.6% (n = 5) of cases after the trial. Spirometric components were significantly improved in N-acetylcysteine group compared to the placebo group: FEV1 (P < 0.0001), FVC (P = 0.014) and FEV1/FVC (P = 0.003). A 4-month trial with 1200 mg oral N-acetylcysteine per day can be used for treating bronchitis, but is also effective in treating bronchiolitis. It also prevents sulfur mustard-induced oxidative stress, and can be used in the treatment of sulfur mustard-induced pulmonary disease.
给予N-乙酰半胱氨酸可能对由氧化-抗氧化失衡引起的疾病有效。我们旨在确定给予4个月的N-乙酰半胱氨酸（每日1200毫克）对肺功能测试正常的患者中硫芥诱导的闭塞性细支气管炎的影响。在一项双盲临床试验中，144例因硫芥导致闭塞性细支气管炎且为0级闭塞性细支气管炎综合征的患者，随机分为第1组（n = 72，N-乙酰半胱氨酸）和第2组（n = 72，安慰剂）。在4个月后使用“差值”（即4个月后的症状评分 - 试验前的症状评分）来测量呼吸困难、晨起呼吸困难、咳嗽和咳痰的变化。在试验开始时、2个月后和4个月后测量肺功能检查结果。与对照组相比，给予N-乙酰半胱氨酸4个月后，呼吸困难（差值：-0.78（0.61），P < 0.001）、晨起呼吸困难（差值：-0.57（0.64），P < 0.001）和咳嗽（差值：-0.86（0.63），P < 0.001）有所改善。N-乙酰半胱氨酸使试验前76.9%（n = 40）的病例咳痰减少至试验后的9.6%（n = 5）。与安慰剂组相比，N-乙酰半胱氨酸组的肺功能检查指标有显著改善：第1秒用力呼气容积（FEV1）（P < 0.0001）、用力肺活量（FVC）（P = 0.014）和FEV1/FVC（P = 0.003）。每日口服1200毫克N-乙酰半胱氨酸进行4个月的试验可用于治疗支气管炎，但对治疗闭塞性细支气管炎也有效。它还可预防硫芥诱导的氧化应激，并可用于治疗硫芥诱导的肺部疾病。
