无创双水平正压通气联合布地奈德在重症支气管哮喘中的应用及对炎症因子IL-6、TNF-a及CRP水平的影响  

Application of noninvasive double-level positive pressure ventilation combined with Budesonide in severe bronchial asthma and its effect on levels of inflammatory cytokines IL-6,TNF-A and CRP

作　　者：雷瑞新 李彩虹 LEI Rui-xin;LI Cai-hong(The First People's Hospital of Zhumadian,Zhumadian Henan 463000,China)

机构地区：[1]驻马店市第一人民医院,河南驻马店463000

出　　处：《医药论坛杂志》2020年第9期33-35,40,共4页Journal of Medical Forum

摘　　要：目的观察支气管哮喘重症患者临床治疗中运用无创双水平正压通气联合布地奈德雾化吸入的效果。方法纳入本组资料者为2017年10月15日—2020年2月10日本院呼吸内科收治的支气管哮喘重症患者70例,均应用无创双水平正压通气联合布地奈德雾化吸入治疗,对患者治疗前、治疗后的肺功能情况[FEV1(一秒用力呼气容积)、FVC(用力肺活量)以及PEF(呼气峰流速)]、生活质量情况、炎性因子[IL-6(白介素-6)、TNF-a(肿瘤坏死因子-ɑ)以及CRP(C-反应蛋白)]水平变化情况等进行对比。结果本组患者治疗的总有效率是92.95%,其中:(1)85例病人治疗后的CRP水平、TNF-a水平以及IL-6水平均较治疗前降低,FEV1、FVC以及PEF水平均较治疗前显著提升,P<0.05。(2)治疗后的PaCO2较治疗前显著降低,PaO2与SaO2均较治疗前显著提升,P<0.05。(3)治疗前QOL评分较治疗后低,差异有统计学意义(P<0.05)。结论在支气管哮喘重症病人的临床治疗中,应用无创双水平正压通气联合布地奈德雾化吸入治疗,能够显著改善患者的支气管炎症,同时又能改善肺功能及血气指标,提高患者生活质量。Objective To observe the effect of noninvasive double-level positive pressure ventilation combined with budesonide atomization inhalation in the clinical treatment of severe bronchial asthma patients.Methods Into this group of data from October 15,2017 to February 102020 Japanese hospital respiratory medicine were 70 cases of severe bronchial asthma patients,all application of noninvasive double the level of positive pressure ventilation joint budesonide aerosol inhalation treatment,the patients of pulmonary function before and after the treatment situation[FEV1,FVC(forced expiratory volume in one second),forced vital capacity and PEF(peak expiratory flow velocity)],quality of life situation,inflammatory factor[IL-6(interleukin 6)and TNF-a(tumor necrosis factor-ɑ)and CRP(C-reactive protein)]level changes,etc.Results The total effective rate of the patients in this group was 92.95%,among which:(1)The CRP level,TNF-A level and IL-6 level of 85 patients after treatment were all lower than that before treatment,and the levels of FEV1,FVC and PEF were all significantly higher than that before treatment,P<0.05.(2)PaCO2 after treatment was significantly lower than that before treatment,and both PaO2 and SaO2 were significantly higher than that before treatment(P<0.05).(3)QOL score before treatment was lower than that after treatment(P<0.05).Conclusion In the clinical treatment of severe bronchial asthma patients,the application of non-invasive double-level positive pressure ventilation combined with budesonide atomization inhalation can significantly improve the bronchial inflammation in patients,and at the same time improve the lung function and blood gas indicators,improve the quality of life of patients,it is suggested to promote actively.

关 键 词：支气管哮喘 机械通气 肿瘤坏死因子-A 白细胞介素-6 生活质量 肺功能 

分 类 号：R562.2[医药卫生—呼吸系统]