摘要
目的探讨噻托溴铵联合无创正压通气对老年慢性阻塞性肺疾病（COPD）并呼吸衰竭患者肺功能及血清脂联素（APN）、超氧化物歧化酶（SOD）、前白蛋白（PAB）水平的影响。方法选取66例老年COPD合并呼吸衰竭患者，按随机数字表法分为对照组与研究组，每组33例。对照组采用常规治疗措施，研究组在常规治疗基础上采用噻托溴铵＋无创正压通气，两组均持续治疗1个月。统计比较两组入院时及疗程结束后肺功能指标[用力肺活量（FVC）、1s用力呼气容积（FEV1）、FEV1／FVC]，血清APN、SOD、PAB水平，血气指标[动脉血二氧化碳分压（PaCO2）、动脉血氧分压（PaO2）]变化情况及病死率。结果治疗后两组FVC、FEV1、FEV1／FVC及血清APN、SOD、PAB水平较治疗前增高，且研究组高于对照组，差异有统计学意义（P〈0．05）。治疗前研究组PaCO2、PaO2水平与对照组比较差异未见统计学意义（P〉0．05）；治疗后，研究组PaCO2低于对照组，PaO2高于对照组，差异有统计学意义（P〈0．05）。研究组病死率（3．03％）低于对照组（24．24％），差异有统计学意义（P〈0．05）。结论无创正压通气联合噻托溴铵治疗老年COPD并呼吸衰竭效果显著，可有效提高患者肺功能，改善血气状态及血清APN、PAB、SOD水平，降低疾病病死率，具有推广价值。
Objective To investigate the effects of tiotropium combined with noninvasive positive pressure ventilation on pulmonary function and levels of serum adiponectin （APN） , superoxide dismutase （SOD） and prealbumin （PAB） in senile patients with chronic obstructive pulmonary disease （COPD） complicated with respiratory failure. Methods Sixty-six senile COPD patients with respiratory failure were divided into control group and study group according to random number table method, with 33 cases in each group. The control group was treated by conventional therapy, the study group was treated with tiotropium bromide ＋ noninvasive positive pressure ventilation on the basis of conventional treatment. Both groups were treated for 1 month. Lung function indexes [ forced vital capacity （FVC） , the first 1 s forced expiratory volume （ FEV1 ） , FEV1/FVC ] , serum APN, SOD, PAB levels, blood gas indexes [ carbon dioxide partial pressure （ PaCO2 ）, oxygen partial pressure （PaO/） ] at the time of admission and after treatment were statistically analyzed. Results After treatment, the levels of FVC, FEV1 and FEV1/FVC of the two groups increased, and those in study group was higher than those in control group, the difference was statistically significant （P 〈 0. 05 ）. The levels of serum APN, SOD and PAB in the two groups were all higher than those before treatment, and those in study group were higher than those in control group, the differences were statistically significant （ all P 〈 0. 05 ）. Before treatment, the PaCO2, PaOz levels in study group were not significant different from those in control group （P 〉 0. 05 ） ; after treatment, the PaCO2 of study group was lower than that of control group, the PaO2 was higher than that of control group, the differences were statistically significant （ all P 〈 0.05 ）. The fatality rate in study group （3.03%） was lower than that in control group （24.24%）, the difference was statistically significant （P 〈 0. 05 ）. Conclusions Noninvasive positive pressure ventilation combined with tiotropium has significant effect on the treatment of COPD complicated with respiratory failure in senile patients. It can improve lung function, blood gas status and levels of serum APN, PAB, SOD and can reduce disease fa- tality rate, which is worthy of promotion.
作者
梁亚丽
赵海港
Liang Yali, Zhao Haigang(Department of ICU, Central Hospital of Xuchang, Xuchang 461000, Chin)
出处
《中国实用医刊》
2018年第1期47-50,共4页
Chinese Journal of Practical Medicine
关键词
噻托溴铵
无创正压通气
肺功能
脂联素
前白蛋白
超氧化物歧化酶
Tiotropium bromide
Noninvasive positive pressure ventilation
Pulmonary function
Adiponectin
Prealbumin
Superoxide dismutase
