乙酰唑胺对慢性阻塞性肺疾病无创通气酸碱平衡的影响  

Effects of acetazolamide on acid-base balance in patients with chronic obstructive pulmonary disease undergiong noninvasive ventilation

作　　者：杨丹芬[1] 宋根红[2] 

机构地区：[1]延安大学附属医院呼吸内科,陕西延安716000 [2]延安大学附属医院重症医学科,陕西延安716000

出　　处：《实用药物与临床》2016年第10期1247-1250,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨乙酰唑胺对慢性阻塞性肺疾病(COPD)无创通气患者酸碱平衡的影响。方法选择2010-2014年急性加重期COPD患者70例,分为乙酰唑胺治疗组(研究组,38例)和非乙酰唑胺治疗组(对照组,32例),测定患者服用乙酰唑胺0、24、48 h后的PaCO_2、HCO_3^-,以及血清、尿液的pH值。结果研究组患者治疗后24、48 h的PaCO_2、HCO_3^-、血清pH值均降低(P<0.05),尿pH值升高(P<0.05),但治疗24 h与48 h比较差异无统计学意义(P>0.05),对照组仅在治疗48 h时HCO_3^-降低,尿pH升高(P<0.05)。研究组无创通气治疗时间较对照组缩短[(5.53±1.72)d vs.(18.81±4.08)d,P<0.001],但两组住院时间比较差异无统计学意义(t=0.418,P=0.877)。结论乙酰唑胺能有效改善COPD患者的PaCO_2、HCO_3^-及血清和尿液的pH值,连续2d服用可缩短无创通气治疗时间。Objective To discuss the effect of acetazolamide on acid-base balance in patients with chronic obstructive pulmonary disease undergiong noninvasive ventilation.Methods Totally 70 patients with acute exacerbation of chronic obstructive pulmonary disease（COPD） from 2010 to 2014 were divided into acetazolamide treatment group（experimental group,n =38） and non-acetazolamide treatment group（control group,n =32）.The PaCO_2,HCO_3^- and the pH value of serum and urine at 0,24 and 48 h after oral administration of acetazolamide were detected.Results PaCO_2,HCO_3^- and serum pH value in patients of experiment group at 24 h and 48 h after treatment decreased significantly（P 〈0.05）,and urinary pH value increased,but there was no significant difference between the indexes at 24 h and 48 h after treatment（P 〉0.05）;the HCO_3^- in control group significantly decreased,while the urinary pH value increased at 48 h after treatment.The ventilation length of experiment group was significantly shorter than that of control group[（5.53 ± 1.72） d vs.（18.81 ±4.08） d,t = 17.197,P 〈0.001],but there was no significant difference in the hospitalization length between the two groups（t =0.418,P = 0.877）.Conclusion Acetazolamide can effectively improve the PaCO_2,HCO_3^- and the pH value of serum and urine in the patients with COPD,and oral administration of acetazolamide for two consecutive days can significantly shorten the noninvasive ventilation time.

关 键 词：乙酰唑胺 慢性阻塞性肺疾病 无创通气 酸碱平衡 

分 类 号：R563.9[医药卫生—呼吸系统]