| 胡海涛,李自健,胡振红,屈 磊,方 瑶.BiPAP正压无创呼吸机辅助治疗老年AECOPD的临床疗效及对患者肺功能、血清炎性因子和预后指标的影响[J].,2021,(12):2275-2279 |
| BiPAP正压无创呼吸机辅助治疗老年AECOPD的临床疗效及对患者肺功能、血清炎性因子和预后指标的影响 |
| Clinical Efficacy of BiPAP Positive Pressure Noninvasive Ventilator in the Treatment of Elderly Patients with AECOPD and Its Influence on Pulmonary Function, Serum Inflammatory Factors and Prognostic Indicators |
| 投稿时间：2020-12-02 修订日期：2020-12-23 |
| DOI：10.13241/j.cnki.pmb.2021.12.017 |
| 中文关键词: 双水平正压无创通气 慢性阻塞性肺疾病急性加重期 疗效 肺功能 炎性因子 预后 |
| 英文关键词: BiPAP noninvasive ventilation Acute exacerbation of chronic obstructive pulmonary disease Curative effect Pulmonary function Inflammatory factors Prognosis |
| 基金项目:国家自然科学基金项目（32071115） |
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| 中文摘要: |
| 摘要 目的：观察双水平正压无创通气（bi-level positive airway pressure，BiPAP）辅助治疗老年慢性阻塞性肺疾病急性加重期（Acute Exacerbation of Chronic Obstructive Pulmonary Disease，AECOPD）的临床疗效以及患者治疗前后肺功能、血清炎性因子和预后指标的变化。方法：选择本院在2017年8月至2020年7月期间收治的150例AECOPD患者，采用随机数字表法分为对照组和研究组，每组75例。给予两组抗感染、祛痰、纠正水电解质紊乱、营养支持等基础治疗，在此基础上给予对照组患者低流量吸氧治疗，给予研究组患者选择合适面罩进行BiPAP治疗。比较两组治疗总有效率以及治疗前和治疗后肺功能指标[1 s用力呼气量（1 s forced expiratory volume，FEV1）、FEV1/用力肺活量（FEV1/forced vital capacity，FEV1/FVC）和FEV1占预计值百分比（FEV1 as a percentage of predicted value，FEV1%）]、血气指标[动脉血氧分压（Arterial partial pressure of oxygen，PaO2）和动脉二氧化碳分压（arterial partial pressure of carbon dioxide，PaCO2）]、血清炎性因子[白细胞介素-6（Interleukin-6，IL-6）、IL-8和肿瘤坏死因子α（TNF-α）水平]、可溶性髓样细胞触发受体-1（soluble triggering receptor expressed on myeloid cells-1，sTREM-1）以及全身性炎症反应综合征（systemic inflammatory response syndrome，SIRS）量化评分。结果：研究组和对照组患者治疗总有率分别为92.00 %和74.67 %（P<0.05）。两组治疗后FEV1、FEV1/FVC、FEV1%、PaCO2、SIRS评分以及血清IL-6、IL-8、TNF-α和sTREM-1水平都明显低于治疗前，PaO2明显高于治疗前（P<0.05）。研究组治疗后FEV1、FEV1/FVC、FEV1%、PaCO2、SIRS评分以及血清IL-6、IL-8、TNF-α和sTREM-1水平都明显低于对照组，PaO2明显高于对照组（P<0.05）。结论：BiPAP能够提高老年AECOPD患者临床疗效，改善肺功能、血气水平和预后，缓解炎症状态。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the clinical efficacy of bi level positive airway pressure (BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in the elderly, and the changes of pulmonary function, serum inflammatory factors and prognostic indicators before and after treatment. Methods: 150 patients with AECOPD in our hospital from August 2017 to July 2020 were selected as the research objects, and were randomly divided into control group and study group, with 75 patients in each group. Two groups of patients were given anti infection, expectorant, correction of water and electrolyte disorders, nutritional support and other basic treatment. On this basis, the control group was given low flow oxygen therapy, and the study group was given the appropriate mask for BiPAP treatment. The total effective rate, pulmonary function indexes [forced expiratory volume (FEV1), FEV1/FVC and FEV1% of predicted value (FEV1%)], blood gas indexes [PaO2 and PaCO2)], serum inflammatory factors [IL-6, IL-8, TNF-α levels], soluble myeloid cell triggering effect were compared between the two groups before and after treatment Quantitative scores of body-1 (sTREM-1) and systemic inflammatory response syndrome (SIRS) were evaluated. Results: The total effective rate of the study group and the control group were 92.00 % and 74.67 %(P<0.05). After treatment, FEV1, FEV1/FVC, FEV1%, PaCO2, SIRS scores and serum levels of IL-6, IL-8, TNF-α and sTREM-1 in the two groups were significantly lower than those before treatment, and PaO2 was significantly lower than that before treatment (P<0.05). After treatment, FEV1, FEV1/FVC, FEV1%, PaCO2, SIRS scores and serum levels of IL-6, IL-8, TNF-α and sTREM-1 in the study group were significantly lower than those in the control group, and PaO2 was significantly higher than that in the control group (P<0.05). Conclusion: BiPAP can improve the clinical efficacy of elderly patients with AECOPD, improve lung function, blood gas level and prognosis, and relieve inflammation. |
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