丹红注射液与布地奈德联合无创正压通气治疗慢性阻塞性肺疾病急性加重并肺源性心脏病患者的临床疗效及其对血清炎性因子水平和心肺功能的影响  

Clinical Effect of Danhong Injection Combined with Budesonide and Non-invasive Positive Pressure Ventilation in Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Heart Disease and the Impact on Serum Inflammato

作　　者：王家珍[1] 梁艳均[2] 李多 WANG Jiazhen;LIANG Yanjun;LI Duo(Department of Critical Care Medicine,the People's Hospital of Santai County,Mianyang,Mianyang 621100,China;Department of Respiratory Medicine,the People's Hospital of Santai County,Mianyang,Mianyang 621100,China;The Second Department of Pulmonary and Critical Care Medicine,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]四川省绵阳市三台县人民医院重症医学科,621100 [2]四川省绵阳市三台县人民医院呼吸内科,621100 [3]西南医科大学附属医院呼吸与危重症医学二科,四川省泸州市646000

出　　处：《实用心脑肺血管病杂志》2019年第8期86-90,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察丹红注射液与布地奈德联合无创正压通气治疗慢性阻塞性肺疾病急性加重(AECOPD)并肺源性心脏病患者的临床疗效,并探讨其对血清炎性因子水平和心肺功能的影响。方法选取2018年5月—2019年5月四川省绵阳市三台县人民医院收治的AECOPD并肺源性心脏病患者120例,随机分为对照组和观察组,每组60例。在常规药物及无创正压通气治疗基础上,对照组患者予以吸入用布地奈德混悬液,观察组患者在对照组基础上予以丹红注射液;两组患者疗程均为14 d。比较两组患者临床疗效,治疗前后血清炎性因子〔包括S100A12、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白介素1β(IL-1β)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)〕水平、动脉血气分析指标〔包括动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、pH值、动脉血氧饱和度(SaO2)〕、肺功能指标〔包括第1秒用力呼气容积占预计值百分比(FEV1%pred)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)〕、心功能指标〔包括左心室射血分数(LVEF)、心排血量(CO)、肺动脉收缩压(PASP)、右心室流出道(ROVT)内径〕,并观察两组患者治疗期间不良反应发生情况。结果(1)观察组患者临床疗效优于对照组(P<0.05)。(2)两组患者治疗前血清S100A12、PCT、hs-CRP、IL-1β、IL-8、TNF-α水平比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后血清S100A12、PCT、hs-CRP、IL-1β、IL-8、TNF-α水平降低(P<0.05)。(3)两组患者治疗前PaCO2、PaO2、pH值、SaO2及FEV1%pred、FEV1/FVC比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后PaCO2降低,PaO2、pH值、SaO2及FEV1%pred、FEV1/FVC升高(P<0.05)。(4)两组患者治疗前LVEF、CO、PASP、ROVT内径比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者治疗后LVEF、CO升高,PASP降低,ROVT内径缩小(P<0.05)。(5)两组患者治疗期间不良反应发Objective To observe the clinical effect of Danhong injection combined with budesonide and noninvasive positive pressure ventilation(NIPPV)in treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary heart disease(PHD),to investigate the impact on serum inflammatory cytokines levels and cardio-pulmonary function.Methods From May 2018 to May 2019,a total of 120 AECOPD patients complicated with PHD were selected in the People's Hospital of Santai County,Mianyang,and they were randomly divided into control group and observation group,with 60 cases in each group.Based on conventional drug treatment and NIPPV,patients in control group received budesonide suspension for inhalation,while patients in observation group received Danhong injection combined with budesonide suspension for inhalation;both groups continuously treated for 14 days.Clinical effect,serum inflammatory cytokines(including S100A12,PCT,hs-CRP,IL-1β,IL-8 and TNF-α)levels,arterial blood-gas analysis results(including PaCO2,PaO2,pH value and SaO2),index of pulmonary function(including FEV1%pred and FEV1/FVC)and cardiac function(including LVEF,CO,PASP and ROVT diameter)before and after treatment were compared between the two group,and incidence of adverse reactions was observed during treatment.Results(1)Compared with control group,the observation group showed better clinical effect(P<0.05).(2)Compared with control group,the observation group showed similar serum levels of S100A12,PCT,hs-CRP,IL-1β,IL-8 or TNF-αbefore treatment(P>0.05),but lower serum levels of S100A12,PCT,hs-CRP,IL-1β,IL-8 and TNF-αafter treatment(P<0.05).(3)Compared with control group,the observation group showed similar PaCO2,PaO2,pH value,SaO2,FEV1%pred or FEV1/FVC before treatmen(t P>0.05),but lower PaCO2,higher PaO2,pH value,SaO2,FEV1%pred and FEV1/FVC(P<0.05).(4)Compared with control group,the observation group showed similar LVEF,CO,PASP or ROVT diameter before treatment(P>0.05),but higher LVEF and CO,lower PASP,and smaller ROVT dia

关 键 词：慢性阻塞性肺疾病 肺源性心脏病 丹红注射液 布地奈德 无创正压通气 炎性因子 治疗结果 

分 类 号：R563.9[医药卫生—呼吸系统]