Abstract:

Objective To study the efficacy of ipratropium bromide combined with N-acety-L-cysteine in patients with chronic obstructive pulmonary disease (COPD) in stable phase, and to analyze the effect of the treatment strategy on serum transforming growth factor beta (TGF-β) and matrix metalloproteinase 9 (MMP-9) levels.Methods A total of 90 COPD patients in Third Hospitals of Anshan from January 2015 to June 2017 were selected. The subjects were divided into the observation group (45 cases) and the control group (45 cases) by draw method. Patients in the control group were treated with ipratropium bromide, whereas patients in the observation group were treated with ipratropium bromide combined with N-acety-L-cysteine. The clinical efficacy, improvement in pulmonary respiratory function, and serum MMP-9 and TGF-β levels were compared between the two groups.Results The effective rate of the observation group (95.6%, 43/45) was higher than that of the control group (71.1%, 32/45), and the difference was statistically significant (χ ²=9.68, P=0.002). After treatment, the forced expiratory volume in one second (FEV₁; (1.87± 0.51)L), forced vital capacity (FVC; (1.75±0.32)L) and FEV₁/FVC ((63.94±5.20)%) of the observation group were better than the control group ((1.62±0.42)L, (1.39±0.16)L, (55.86±6.42)%). The differences were statistically significant (t=2.68, 7.40, 6.71, all P<0.01). After treatment, the serum TGF-β ((82.98±7.36) ng/L) and MMP-9 ((86.25±6.98)μg/L) levels in the observation group were higher than those of the control group ((93.03±7.91) ng/L, (96.75±8.73)μg/L). The difference were statistically significant (t=5.89, 6.13, all P<0.01). Conclusion Ipratropium bromide combined with N-acety-L-cysteine has significant efficacy in the treatment of COPD in stable phase. It can reduce the levels of TGF-β and MMP-9.

Key words: Pulmonary disease, chronic obstructive, Ipratropium, Acetylcysteine, Transforming growth factor beta, Matrix metalloproteinase 9, Comparative effectiveness research