The Influence Of N-acetylcysteine For Oxidative Stress Of Acute Exacerbation Chronic Obstructive Pulmonary Disease Patients

Objective:Through measuring the serum glutathione S-tramsferases(GSH-ST) activity, inhibition to hydroxyl radical and superoxide radicalbefore and after application N-acetylcysteine (NAC) for Acute exacerbation ofchronic obstructive pulmonary disease (AECOPD) patients, to study theinfluence of N-acetylcysteine for oxidative stress and provide the theorybasis in treatment to the oxidation/antioxidation imbalance of AECOPDpatients.Methods: Forty AECOPD patients diagnosed by lung function testing(based on the guideline for diagnosis and treatment of the chronic obstructivepulmonary disease, Respiratory disease branch, Chinese Medical Association,revised edition2007) were randomly divided into three groups: groupⅠ weregiven the conventional treatment (20cases), groupⅡ were combined withN-acetylcysteine treatment (20cases), group Ⅲwere healthy control group (20cases). There were no significant differences of gender, age and body massindex in three groups. Venous blood were taken before the N-acetylcysteinetreatment in all three groups, and after the treatment in group Ⅰ and Ⅱ, thenmeasured the glutathione S-tramsferases (GSH-ST) activity, inhibition tohydroxyl radical and superoxide radical by the colorimetric method. The dataswere compared respectively in three groups, and analyzed the correlations.Results:1. Serum GSH-ST activity: the conventional treatment groupbefore treatment is20.55±4.04(U/ml), the NAC treatment group beforetreatment is20.37±4.48(U/ml), two groups have no statistically difference (t=0.441, P>0.05); Healthy control group is11.07±2.44(U/ml), and there arestatistically difference between the two treatment groups and the healthycontrol group (t=14.351, P<0.05; t=12.426，P＜0.05). The conventionaltreatment group after treatment is20.76±3.89(U/ml), the NAC treatment group after treatment is22.67±4.49(U/ml), two groups have statisticallydifference (t=2.775，P＜0.05), it has not statistically difference betweenbefore and after treatment of the conventional treatment group(t=-1.699，P>0.05), but has statistically difference between before and after treatment ofthe NAC treatment group(t=-3.011，P＜0.05).2. Serum inhibition to hydroxyl radical: the conventional treatment groupbefore treatment is565.76±161.29(U/ml), the NAC treatment group beforetreatment is575.70±143.94(U/ml), two groups have not statisticallydifference (t=0.778, P>0.05); the healthy control group is680.57±167.72(U/ml), and has statistically significant compared with theconventional treatment group and the NAC treatment group before treatment(t=7.281，P＜0.05; t=7.21, P<0.05). The conventional treatment group aftertreatment is574.39±171.88(U/ml), the NAC treatment group after treatmentis687.94±153.49(U/ml), two groups have statistically significant difference(t=-8.449，P＜0.05), the conventional treatment group before and aftertreatment have not statistically significant difference (t=1.023，P>0.05), theNAC treatment group before and after treatment have statistically significantdifference (t=-9.292, P <0.05).3serum inhibition to superoxide radical: the conventional treatment groupbefore treatment is116.27±24.26(U/L), the NAC treatment group beforetreatment is117.85±24.07(U/L), two groups have not statistically difference(t=3.658, P>0.05); the healthy control group is125.05±7.56(U/L), and thereare statistically significant compared with the conventional treatment groupand the NAC treatment group before treatment(t=2.26, P<0.05; t=1.876，P＜0.05). The conventional treatment group after treatment is119.30±29.58(U/L),the NAC treatment group after treatment is129.92±26.01(U/L), two groupshave statistically significant difference (t=-3.277，P＜0.05). there has notstatistically significant difference before and after treatment in theconventional treatment group(t=-1.380， P>0.05), but has statisticallysignificant difference before and after treatment in the NAC treatment group(t=-6.401, P <0.05). Conclusion:1. Serum glutathione S-tramsferases (GSH-ST) activity,inhibition to hydroxyl radical and superoxide radical reduced in AECOPDpatients, indicate the existence of oxidatie/antioxidant imbalance.2. After the N-acetylcysteine treatment, Serum glutathione S-tramsferases(GSH-ST) activity, inhibition to hydroxyl radical and superoxide radicalelevated in AECOPD patients, indicate the NAC has antioxidant effect.3. Serum glutathione S-tramsferases (GSH-ST) activity, inhibition to hydroxylradical and superoxide radical can be the evaluation indexes of treatment andprognosis of AECOPD patients.4. N-acetylcysteine can improve the oxidatie/antioxidant imbalance ofAECOPD patients.