摘要
目的:观察甲强龙联合BiPAP呼吸机治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的疗效。方法:选取106例AECOPD合并呼吸衰竭患者为研究对象,依据治疗方式不同分为对照组(n=42)和观察组(n=64)。对照组患者采用常规对症及BiPAP治疗;观察组患者在对照组基础上联合甲强龙治疗,疗程均为两周。比较两组患者治疗两周后疗效;6 h乳酸清除率;治疗前及治疗两周后炎症因子[降钙素原(PCT)、C反应蛋白(CRP)、C1q肿瘤坏死因子相关蛋白5(CTRP-5)、不规则趋化因子(FKN)]、肺功能[1s用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]、呼吸力学指标[气道峰值(Ppeak)、平台压(Pplat)、呼吸阻力(Raw)、胸肺动态顺应性(Cd)]、生活质量[CAT评分]水平。结果:治疗两周后,两组患者总有效率无统计学差异(P>0.05);观察组患者6 h乳酸清除率高于对照组(P<0.05);患者肺功能指标(FEV1、FEV1/FVC)、Cd水平高于治疗前及同期对照组(P<0.05);炎症因子(PCT、CRP、CTRP-5、FKN)、Ppeak、Pplat、Raw、CAT评分均低于治疗前及同期对照组(P<0.05)。结论:甲强龙联合BiPAP治疗AECOPD合并呼吸衰竭能够提升乳酸清除率和肺功能,改善患者炎症和呼吸力学,提升生活质量。
Objective:To study the effect of methylprednisolone combined with BiPAP ventilator in the treatment of patients with AECOPD complicated with respiratory failure.Methods:106 patients with AECOPD complicated with respiratory failure were selected as the research objects.Taking treatment method as grouping basis, 42 cases with conventional symptomatic therapy and BiPAP were included in control group, and 64 cases who were combined with methylprednisolone on the basis of control group were enrolled as observation group, and the course of treatment was two weeks.The efficacy and 6 h lactic acid clearance rate, the inflammatory factors [PCT,CRP,C1 q tumor necrosis factor-related protein 3(CTRP-5),fractalkine(FKN)],lung function [forced expiratory volume in 1 s(FEV1),FEV1/forced vital capacity(FVC)],respiratory mechanics indicators [airway peak(Ppeak),platform pressure(Pplat),respiratory resistance(Raw),thoracopulmonary dynamic compliance(Cd)] and quality of life [COPD Assessment Test(CAT)] were compared between the two groups before treatment and after 2 weeks of treatment.Results:After 2 weeks of treatment, there was no significant difference in the total effective rate between the two groups(P>0.05),and the 6 h lactic acid clearance rate of observation group was higher than that of control group(P<0.05).The levels of lung function indicators(FEV1,FEV1/FVC) and Cd in observation group were higher than those before treatment and those in control group during the same period while the inflammatory factors(PCT,CRP,CTRP-5,FKN),Ppeak, Pplat, Raw and CAT score were lower than those before treatment and those in control group during the same period(P<0.05).Conclusion:Methylprednisolone combined with BiPAP ventilator in the treatment of AECOPD with respiratory failure can increase the 6 h lactic acid clearance rate and lung function, improve the inflammation and respiratory mechanics, and enhance the quality of life of patients.
作者
张逍
张传红
ZHANG Xiao;ZHANG Chuan-hong(Department of Pulmonary Disease,Nanjing Pukou Hospital of Traditional Chinese Medicine,Nanjing 211800,Jiangsu,China)
出处
《川北医学院学报》
CAS
2022年第11期1472-1475,共4页
Journal of North Sichuan Medical College
关键词
甲强龙
双水平气道正压通气
慢性阻塞性肺疾病急性加重期
呼吸衰竭
肺功能
Methylprednisolone
Bilevel positive airway pressure
Acute exacerbation of chronic obstructive pulmonary disease
Respiratory failure
Lung function
作者简介
张逍(1986-),男,主治医师。E-mail:zhangxiao220110@163.com;通讯作者:张传红。E-mail:redzhangpp@163.com。
