噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响  

The effect of tiotropium bromide combined with noninvasive ventilator on blood gas indicators,respiratory function and inflammatory factors in pneumoconiosis complicated with respiratory failure patients

作　　者：王庭 童峰[2] Wang Ting;Tong Feng(Department of Respiratory Medicine,Qingyang County People’s Hospital,Qingyang Anhui 247000,China;South China Agricultural University Hospital,Guangzhou 510642,China)

机构地区：[1]安徽省青阳县人民医院呼吸内科,安徽青阳247000 [2]华南农业大学医院,广州510642

出　　处：《保健医学研究与实践》2020年第4期36-41,共6页Health Medicine Research and Practice

基　　金：广东省省级科技计划项目(2015A020224030)。

摘　　要：目的探讨噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响。方法选取2018年4月-2019年11月安徽省某医院收治的110例尘肺并发呼吸衰竭患者为研究对象,采用随机数字表法分为对照组(55例)和研究组(55例)。对照组患者采用噻托溴铵治疗,研究组患者采用噻托溴铵联合无创呼吸机治疗,2组患者均持续治疗14d。比较2组患者临床效果;比较2组患者治疗前后心率、呼吸频率、血气指标[动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、血氧饱和度(SaO2)及血浆pH值]、呼吸力学指标[气道峰压(Ppeak)、静态顺应性(Cst)及气道阻力(RAW)]、炎性因子指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-27(IL-27)及降钙素原(PCT)]。结果治疗前,2组患者心率,呼吸频率,PaO2,PaCO2,SaO2及血浆pH值比较,差异均无统计学意义(P>0.05);治疗后,2组患者心率、呼吸频率及PaCO2均明显低于治疗前,且研究组患者低于对照组,差异均有统计学意义(P<0.05);治疗后,2组患者PaO2及SaO2均明显高于治疗前,且研究组患者高于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者Ppeak,Cst及RAW比较,差异均无统计学意义(P>0.05)。治疗后,2组患者Ppeak及RAW均明显低于治疗前,且研究组患者低于对照组,差异均有统计学意义(P<0.05);治疗后,2组患者Cst明显高于治疗前,且研究组患者高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者CRP,TNF-α,IL-27及PCT水平比较,差异均无统计学意义(P>0.05)。治疗后,2组患者CRP,TNF-α,IL-27及PCT水平均明显低于治疗前,且研究组患者低于对照组,差异均有统计学意义(P<0.05)。对照组患者发生不良反应5例(口咽干燥2例、头晕2例、恶心1例),不良反应发生率为9.09%;研究组患者发生不良反应5例(口咽干燥1例、头晕2例、恶心1例、胃部胀气1例),不良反应发生率为9.09Objective To investigate the effects of tiotropium bromide combined with non-invasive ventilator therapy on blood gas index,respiratory function and inflammatory factor levels in patients with pneumoconiosis complicated with respiratory failure.Methods A total of 110 patients with pneumoconiosis and respiratory failure who were admitted to a hospital in Anhui Province from April 2018 to November 2019 were selected as the research subjects.The patients were divided into a control group(55 cases)and a study group(55 cases)using a random number table method.Patients in the control group were treated with tiotropium bromide,patients in the study group were treated with tiotropium bromide combined with non-invasive ventilator,and the patients in both groups were continuously treated for 14 days.Compare the clinical effects of the two groups of patients;compare the heart rate,respiratory rate,and blood gas indexes of the two groups of patients before and after treatment[arterial blood oxygen pressure(PaO2),arterial carbon dioxide pressure(PaCO2),blood oxygen saturation(Sa O2),and plasma p H value],Respiratory mechanics indicators[peak air pressure(Ppeak),static compliance(Cst)and airway resistance(RAW)],inflammatory factor indicators[C reactive protein(CRP),tumor necrosis factor-α(TNF-α),Interleukin-27(IL-27)and procalcitonin(PCT)].Results Before treatment,there was no significant difference in heart rate,respiratory rate,Pa O2,Pa CO2,Sa O2 and plasma p H between the two groups(P>0.05).After treatment,the heart rate,respiratory rate,and Pa CO2 of the two groups were significantly lower than before treatment,and the patients in the study group were lower than the control group,and the differences were statistically significant(P<0.05);Pa O2 and Sa O2 were significantly higher in the two groups.Before treatment,and the patients in the study group were higher than the control group,the differences were statistically significant(P<0.05);the plasma p H values of the two groups were higher than before treatment,and the dif

关 键 词：噻托溴铵 无创呼吸机 尘肺并发呼吸衰竭 血气指标 呼吸功能 炎性因子 

分 类 号：R563[医药卫生—呼吸系统]