- 乙酰半胱氨酸治疗慢性阻塞性肺疾病的疗效：Meta 分析。
The efficacy of -acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis.
机构信息
Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Min-Sheng Road, Dalin Town, Chiayi County.
Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin Town.
出版信息
Ther Adv Respir Dis. 2023 Jan-Dec;17:17534666231158563. doi: 10.1177/17534666231158563.
BACKGROUND
-acetylcysteine (NAC) may reduce acute exacerbations of chronic obstructive pulmonary disease through an antioxidant effect. Due to the heterogeneity in studies, the currently available data do not confirm the efficacy of oral NAC therapy in chronic obstructive pulmonary disease patients. We hypothesize that chronic obstructive pulmonary disease patients receiving regular oral NAC therapy do not achieve improved clinical outcomes.
OBJECTIVES
The purpose of this meta-analysis was to determine the efficacy of long-term oral NAC therapy in chronic obstructive pulmonary disease patients.
DATA SOURCES AND METHODS
The literature search was performed using the PubMed, Web of Science, and Cochrane Library databases to identify all included clinical studies. Studies were eligible for inclusion only if they directly compared the outcomes of NAC placebo in adults with chronic obstructive pulmonary disease between 1 January 2000 and 30 May 2022. All studies were included if they reported one or more of the following outcomes: number of patients with no acute exacerbations, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), St George's Respiratory Questionnaire score, glutathione level, and adverse events.
RESULTS
Nine randomized controlled trials were included in the meta-analysis. There were 1061 patients in the NAC group and 1076 patients in the placebo group. The current meta-analysis provides evidence that the number of patients with no acute exacerbations (965 patients receiving NAC therapy, 979 control group patients), change in FEV1 (433 patients receiving NAC therapy, 447 control group patients), change in FVC (177 patients receiving NAC therapy, 180 control group patients), change in St George's Respiratory Questionnaire score (128 patients receiving NAC therapy, 131 control group patients), change in glutathione levels (38 patients receiving NAC therapy, 40 control group patients), and adverse events (832 patients receiving NAC therapy, 846 control group patients) were not significantly different between the two groups.
CONCLUSION
NAC did not reduce the risk of acute exacerbation or ameliorate the decline in lung volume in chronic obstructive pulmonary disease patients.
背景
-乙酰半胱氨酸（NAC）可能通过抗氧化作用减少慢性阻塞性肺疾病的急性加重。由于研究的异质性，目前可用的数据并不能证实口服 NAC 治疗在慢性阻塞性肺疾病患者中的疗效。我们假设接受常规口服 NAC 治疗的慢性阻塞性肺疾病患者不会获得改善的临床结局。
目的
本荟萃分析的目的是确定长期口服 NAC 治疗在慢性阻塞性肺疾病患者中的疗效。
数据来源和方法
通过 PubMed、Web of Science 和 Cochrane Library 数据库进行文献检索，以确定所有纳入的临床研究。只有直接比较了 2000 年 1 月 1 日至 2022 年 5 月 30 日期间成人慢性阻塞性肺疾病患者中 NAC 与安慰剂的结果的研究才符合纳入标准。如果研究报告了以下一个或多个结果，则将其纳入：无急性加重的患者数量、1 秒用力呼气量（FEV1）、用力肺活量（FVC）、圣乔治呼吸问卷评分、谷胱甘肽水平和不良事件。
结果
共有 9 项随机对照试验纳入荟萃分析。NAC 组有 1061 例患者，安慰剂组有 1076 例患者。目前的荟萃分析提供了证据表明，无急性加重的患者数量（965 例接受 NAC 治疗的患者，979 例对照组患者）、FEV1 的变化（433 例接受 NAC 治疗的患者，447 例对照组患者）、FVC 的变化（177 例接受 NAC 治疗的患者，180 例对照组患者）、圣乔治呼吸问卷评分的变化（128 例接受 NAC 治疗的患者，131 例对照组患者）、谷胱甘肽水平的变化（38 例接受 NAC 治疗的患者，40 例对照组患者）和不良事件（832 例接受 NAC 治疗的患者，846 例对照组患者）在两组之间没有显著差异。
结论
NAC 并未降低慢性阻塞性肺疾病患者急性加重的风险或改善肺容积下降。
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