BiPAP联合百令胶囊对COPD并发Ⅱ型呼吸衰竭患者血气指标和心肺功能的影响  

Effects of BiPAP Ventilation Combined with Bailing Capsule on Blood Gas Indexes and Cardiopulmonary Function in Patients with COPD Complicated with Type Ⅱ Respiratory Failure

作　　者：苏勇[1] 魏卿[1] 蒋春华[2] SU Yong;WEI Qing;JIANG Chunhua(Pengzhou People' s Hospital,Pengzhou 611930,Sichuan,China;Guangxi Medical University,Nanning 530021,Guangxi,China)

机构地区：[1]彭州市人民医院,四川彭州611930 [2]广西医科大学,广西南宁530021

出　　处：《贵州医科大学学报》2019年第7期838-843,共6页Journal of Guizhou Medical University

基　　金：国家自然科学基金(81560408)

摘　　要：目的:观察双水平气道正压(BiPAP)通气联合百令胶囊对慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭患者血气指标和肺功能的影响。方法:104例COPD合并Ⅱ型呼吸衰竭患者分为观察组(n=48)和对照组(n=56),对照组采用BiPAP通气治疗,观察组采用BiPAP通气联合百令胶囊治疗;于治疗前、治疗2周及治疗8周时,采用动脉血气分析仪检测两组患者外周动脉血血氧分压(PaO2)、二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、pH值,采用肺功能检测仪检测第一秒用力呼气容积(FEV1)、FEV1与用力呼气肺活量(FVC)比值(FEV1/FVC)、呼气峰值流速占预计值比(PEF%);于治疗前及治疗8周时采用流式细胞术检测两组患者外周血T淋巴细胞亚群(CD3^+、CD4^+、CD4^+/CD8^+)指标,采用酶联免疫法检测血清转化生长因子(TGF-β1)、基质金属蛋白酶-9(MMP-9)及金属蛋白酶组织抑制因子-1(TIMP-1)水平;比较两组患者治疗2周和8周时的治疗效果。结果:治疗2周及8周时,两组患者PaO2、SaO2、pH、FEV1、FEV1/FVC及PEF%均显著高于治疗前,PaCO2显著低于治疗前(P<0.05),观察组PaO2、PaCO2、SaO2变化显著大于对照组同时间点(P<0.05);治疗8周时,观察组FEV1、FEV1/FVC及PEF%显著高于治疗2周时(P<0.05),两组患者CD3^+、CD4^+、CD4^+/CD8^+均显著高于治疗前(P<0.05),TGF-β1、MMP-9显著低于治疗前、TIMP-1显著高于治疗前(P<0.05),且观察组上述指标变化显著大于对照组(P<0.05);观察组治疗2周和治疗8周时的总有效率(87.50%、95.83%)均显著高于对照组同时间点的总有效率(69.64%、75.00%,P<0.05)。结论:BiPAP通气联合百令胶囊治疗COPD并发Ⅱ型呼衰能有效改善患者血气指标、肺功能、免疫功能及炎性水平,提高临床疗效。Objective:To observe the effects of bilevel positive airway pressure(BiPAP)ventilation combined with Bailing capsule on blood gas indexes and cardiopulmonary function in patients with chronic obstructive pulmonary disease(COPD)complicated with typeⅡrespiratory failure.Methods:Patients with COPD complicated with typeⅡrespiratory failure were divided into observation group(n=48)and control group(n=56).The control group was treated with BiPAP ventilation,and the observation group was treated with BiPAP ventilation combined with Bailing capsule.Before treatment and after 2 and 8 weeks treatment,peripheral arterial partial pressure of oxygen(PaO 2),partial pressure of carbon dioxide(PaCO 2),arterial oxygen saturation(SaO 2)and pH value were measured by arterial blood gas analyzer.The forced breath volume(FEV1),the ratio of FEV1 to forced vital capacity(FEV1/FVC)and the ratio of peak flow velocity to predicted value(PEF%)were measured by pulmonary function detector.Peripheral blood T lymphocyte subsets(CD 3^+,CD 4^+,CD 4^+/CD 8^+)were measured by flow cytometry before treatment and after 8 weeks treatment,and the levels of serum transforming growth factor(TGF-β1),matrix metalloprotease-9(MMP-9)and tissue inhibitor of metalloprotease-1(TIMP-1)were measured by enzyme-linked immunosorbent assay(Elisa).The therapeutic effects were compared between the two groups at 2 and 8 weeks.Results:At 2 and 8 weeks of treatment,PaO 2,SaO 2,pH,FEV1,FEV1/FVC and PEF%in both groups were significantly higher than those before treatment,and PaCO 2 was significantly lower than that before treatment(P<0.05).The change of PaO 2,PaCO 2 and SaO 2 in the observation group was significantly higher than that in the control group at the same time(P<0.05).At 8 weeks of treatment,FEV1,FEV1/FVC and PEF%in the observation group were significantly higher than those at the second week of treatment(P<0.05),and CD 3^+,CD 4^+and CD 4^+/CD 8^+in both groups were significantly higher than those before treatment(P<0.05).TGF-β1 and MMP-9 were significantl

关 键 词：慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 双水平气道正压通气 百令胶囊 血气指标 肺功能 

分 类 号：R563.8[医药卫生—呼吸系统]