BiPAP呼吸机联合坎地沙坦酯对AECOPD患者的疗效与安全性  

Effects of BiPAP ventilator combined with candesartan cilexetil on blood gas indexes,cardiopulmonary function and levels of serum COX-2,PGE2 and PLA2 in patients with AECOPD

作　　者：贺孟君 张家艳[1] 李燕舞[1] 杨旖 陈敏[1] HE Mengjun;ZHANG Jiayan;LI Yanwu;YANG Yi;CHEN Min(Department of Respiratory and Critical Care Medicine,Chengdu Third People′s Hospital,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院呼吸与危重症医学科,四川成都610031

出　　处：《西部医学》2022年第6期896-901,907,共7页Medical Journal of West China

基　　金：成都市高水平临床重点专科建设项目(H18019)。

摘　　要：目的探讨双水平气道正压通气(BiPAP)呼吸机联合坎地沙坦酯对慢性阻塞性肺疾病急性加重期(AECOPD)患者血气指标、心肺功能、血清环氧化酶-2(COX-2)、前列腺素E2(PGE2)、磷脂酶A2(PLA2)水平的影响。方法对我院2019年10月~2021年1月收治的AECOPD患者进行标号,采用计算机随机选取其中142例为研究对象,并按照随机数字表法分为观察组和对照组,每组71例。对照组给予BiPAP呼吸机治疗,观察组在对照组基础上加坎地沙坦酯治疗。比较两组疗效、治疗前及治疗2周后血气指标、心肺功能、血清COX-2、PGE2、PLA2水平及不良反应。结果治疗2周后,观察组临床有效率为94.37%,对照组为83.10%,两组差异有统计学意义(P<0.05);其中两组支气管哮喘、慢性肺气肿患者临床疗效比较,差异无统计学意义(P>0.05)。治疗2周后,两组血气指标氧分压(PaO_(2))、氧饱和度(SaO_(2))水平及pH值显著升高,二氧化碳分压(PaCO_(2))水平显著降低,且治疗后两组组间对比差异有统计学意义(均P<0.05);两组左心射血分数(LVEF)、第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)及第一秒用力呼气容积占用肺活量百分比(FEV_(1)/FVC)显著升高,心率(HR)显著降低,且治疗后组间对比差异有统计学意义(均P<0.05);治疗2周后,两组血清白细胞介素1β(IL-1β)、血清环氧化酶-2(COX-2)、前列腺素E2(PGE2)、磷脂酶A2(PLA2)水平显著降低,且治疗后组间对比差异有统计学意义(均P<0.05);治疗期间,两组总不良反应率、各亚组不良反应率相比,差异无统计学意义(均P>0.05)。结论BiPAP呼吸机联合坎地沙坦酯治疗AECOPD,可显著提高治疗效果,改善患者血气状态及心肺功能,降低机体炎症,不良反应少、安全性好。Objective To explore the effects of bi-level positive airway pressure(BiPAP)ventilator combined with candesartan cilexetil on blood gas indexes,cardiopulmonary function and levels of serum cyclooxygenase-2(COX-2),prostaglandin E2(PGE2)and phospholipase A2(PLA2)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Totally 142 patients with AECOPD in the department of respiratory medicine of our hospital were randomly selected as the research subjects.According to the random number table method,they were divided into observation group and control group,with 71 cases in each group.Control group was treated with BiPAP ventilator,and observation group was treated with candesartan cilexetil.The efficacy,blood gas indexes,cardiopulmonary function,levels of serum COX-2,PGE2 and PLA2 and adverse reactions before treatment and after 2 weeks of treatment were compared between the two groups.Results After 2 weeks of treatment,the clinical effective rate was 94.37%in observation group and was 83.10%in control group(P<0.05),there was no significant difference in clinical efficacy between the two groups in bronchial asthma and chronic emphysema(P>0.05).After 2 weeks of treatment,the blood gas indexes of partial pressure of blood oxygen(PaO_(2)),oxygen saturation(SaO_(2))and pH value were significantly increased in the two groups(P<0.05)while partial pressure of carbon dioxide(PaCO_(2))was significantly reduced(P<0.05),and there were significant differences between groups after treatment(P<0.05).The left ventricular ejection fraction(LVEF),forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC)and percentage of forced expiratory volume in the first second and forced vital capacity(FEV_(1)/FVC)were significantly increased in the two groups(P<0.05)while heart rate(HR)was significantly decreased(P<0.05),and the differences between the groups were significant after treatment(P<0.05).After 2 weeks of treatment,the levels of serum interleukin 1β(IL-1β),serum cyclooxygen

关 键 词：慢性阻塞性肺疾病 血气指标 心肺功能 机体炎症 

分 类 号：R563.8[医药卫生—呼吸系统]