吸入 N-乙酰半胱氨酸支气管肺泡灌洗治疗重症肺炎的疗效及炎症调节作用
Therapeutic outcomes and inflammatory modulation of inhaled N-acetylcysteine bronchoalveolar lavage in severe pneumonia.
作者信息
Long Shuzhen, Qin Huazhao, Guo Jing, Liu Lihua
机构信息
Clinical Medical College, Guangxi Health Science College Nanning 530031, Guangxi, China.
Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, China.
出版信息
Am J Transl Res. 2025 Aug 15;17(8):6630-6638. doi: 10.62347/CDJX3226. eCollection 2025.
OBJECTIVE
To evaluate the therapeutic efficacy of inhaled N-acetylcysteine (NAC) bronchoalveolar lavage (iNAC-BAL) in severe pneumonia (SP) and explore its effects on inflammatory cytokines modulation.
METHODS
A total of 146 SP cases were assigned to two groups: the control group received bronchoalveolar lavage with isotonic saline (0.9% NaCl) alone, while the observation group received additional NAC aerosol inhalation. Clinical efficacy, Acute Physiology and Chronic Health Evaluation (APACHE) II scores, intensive care unit (ICU) stay, duration of ventilator dependence, adverse reactions, symptom resolution times, respiratory mechanics, pulmonary function, inflammatory cytokines, and humoral immunity were assessed and compared between the two groups.
RESULTS
The observation group achieved better therapeutic effects (P=0.007), with significantly lower APACHE II scores, shorter ICU stays, reduced ventilator dependence, faster symptom resolution, and fewer adverse events (all P<0.05). Additionally, respiratory dynamics, lung function, inflammatory cytokines, and humoral immunity improved markedly in the observation group compared with the control group (all P<0.05).
CONCLUSION
iNAC-BAL demonstrates significant clinical efficacy and potent anti-inflammatory effects in the management of SP.
目的
评估吸入N - 乙酰半胱氨酸（NAC）支气管肺泡灌洗（iNAC - BAL）治疗重症肺炎（SP）的疗效，并探讨其对炎症细胞因子调节的影响。
方法
将146例SP患者分为两组：对照组仅用等渗盐水（0.9% NaCl）进行支气管肺泡灌洗，观察组在此基础上增加NAC雾化吸入。评估并比较两组的临床疗效、急性生理与慢性健康状况评分系统（APACHE）Ⅱ评分、重症监护病房（ICU）住院时间、呼吸机依赖时间、不良反应、症状缓解时间、呼吸力学、肺功能、炎症细胞因子和体液免疫。
结果
观察组取得了更好的治疗效果（P = 0.007），APACHEⅡ评分显著更低，ICU住院时间更短，呼吸机依赖减少，症状缓解更快，不良事件更少（均P < 0.05）。此外，与对照组相比，观察组的呼吸动力学、肺功能、炎症细胞因子和体液免疫明显改善（均P < 0.05）。
结论
iNAC - BAL在SP的治疗中显示出显著的临床疗效和强大的抗炎作用。
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