摘要
目的探讨噻托溴铵联合无创正压通气治疗对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者生化指标的影响。方法选取2015年7月至2018年6月西安市第四医院收治的老年COPD合并呼吸衰竭患者70例作为研究对象,按照随机数表法将患者分为观察组对照组,每组35例,均进行常规治疗,对照组采取噻托溴铵治疗,观察组采取噻托溴铵联合无创正压通气治疗,治疗时间为1个月。比较两组患者治疗前后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC],血气指标[动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)]以及血清脂联素(APN)、超氧化物歧化酶(SOD)、前白蛋白(PAB)水平。结果观察组患者治疗前的FVC、FEV1、FEV1/FVC与对照组比较差异均无统计学意义(P>0.05);观察组患者治疗后的FVC、FEV1、FEV1/FVC分别为(2.38±0.28)L、(1.77±0.75)L、(73.55±9.88)%,明显高于对照组的(2.08±0.41)L、(1.21±0.33)L、(63.61±8.39)%,差异均有统计学意义(P<0.05);治疗前观察组患者的PaO2、PaCO2与对照组比较差异均无统计学意义(P>0.05);治疗后观察组患者的PaO2为(87.15±7.22)mmHg,明显高于对照组的(67.24±7.19)mmHg,PaCO2为(45.32±5.17)mmHg,明显低于对照组的(57.72±6.87)mmHg,差异均有统计学意义(P<0.05);观察组患者治疗前的APN、SOD、PAB水平与对照组比较差异均无统计学意义(P>0.05);治疗后,观察组患者的血清APN、SOD、PAB水平分别为(13.36±2.76)mg/L、(92.36±12.21)U/mg、(203.54±33.93)mg/L,明显高于对照组的(11.23±2.55)mg/L、(75.7±10.45)U/mg、(163.57±31.41)mg/L,差异均有统计学意义(P<0.05)。结论噻托溴铵联合无创正压通气治疗老年COPD合并呼吸衰竭可有效改善患者的肺功能、血气状态,提高血清APN、SOD、PAB水平,治疗效果显著。
Objective To investigate the effects of tiotropium bromide and non-invasive positive pressure ventilation on biochemical parameters of elderly patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods A total of 70 elderly patients with COPD and respiratory failure who were treated in the Fourth Hospital of Xi'an from July 2015 to June 2018 were selected as the research subjects.The patients were divided into the observation group and the control group according to the random number table method.Each group had 35 patients.The control group was treated with tiotropium bromide,and the observation group was treated with tiotropium bromide and non-invasive positive pressure ventilation.The treatment lasted 1 month.The lung function indexes(forced vital capacity[FVC],forced expiratory volume in one second[FEV1],FEV1/FVC),blood gas indexes(arterial oxygen pressure[PaO2],arterial carbon dioxide pressure[PaCO2])before and after treatment were compared between the two groups,as well as serum adiponectin(APN),superoxide dismutase(SOD),and prealbumin(PAB)levels.Results There were no significant differences in FVC,FEV1,and FEV1/FVC between the observation group and the control group(P>0.05).The FVC,FEV1,and FEV1/FVC of the observation group were(2.38±0.28)L,(1.77±0.75)L,(73.55±9.88)%,significantly higher than(2.08±0.41)L,(1.21±0.33)L,(63.61±8.39)%in the control group(P<0.05).There were no significant differences in PaO2 and PaCO2 between the observation group and the control group before treatment(P>0.05).The PaO2 of the observation group was(87.15±7.22)mmHg after treatment,significantly higher than(67.24±7.19)mm in the control group,and PaCO2 were(45.32±5.17)mmHg,significantly lower than(57.72±6.87)mmHg in the control group(P<0.05).There were no significant differences in the levels of APN,SOD,and PAB between the two groups before treatment(P>0.05).The levels of serum APN,SOD and PAB in the observation group were(13.36±2.76)mg/L,(92.36±12.21)U/mg,(203.54±33.93)mg/L,significantly higher than(11.23±2.55)mg/L,(75.7±10.45)U/mg,(163.57±31.41)mg/L in the control group(P<0.05).Conclusion Tiotropium bromide and non-invasive positive pressure ventilation in the treatment of elderly patients with COPD combined with respiratory failure can effectively improve the lung function and blood gas status of patients,and improve serum APN,SOD,PAB levels,with significant treatment effect.
作者
赵立群
万印利
张娟妮
徐灵彬
ZHAO Li-qun;WAN Yin-li;ZHANG Juan-ni;XU Ling-bin(Department of Respiratory Medicine,the Fourth Hospital of Xi'an,Xi'an 710004,Shaanxi,CHINA;School of Public Health,Xi'an Medical College,Xi'an 710021,Shaanxi,CHINA;Department of Respiratory Medicine,Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi,CHINA)
出处
《海南医学》
CAS
2020年第1期34-37,共4页
Hainan Medical Journal
关键词
噻托溴铵
无创正压通气
慢性阻塞性肺疾病
呼吸衰竭
肺功能
血气指标
脂联素
超氧化物歧化酶
前白蛋白
Tiotropium bromide
Non-invasive positive pressure ventilation
Chronic obstructive pulmonary disease
Respiratory failure
Pulmonary function
Blood gas index
Adiponectin
Superoxide dismutase
Prealbumin
