经鼻高流量氧疗治疗AECOPD合并轻度Ⅱ型呼吸衰竭对患者血气分析指标及CTGF、ET-1、TGF-β1指标水平的影响  

Effects of transnasal high flow oxygen therapy on blood gas analysis indexes,CTGF,ET-1 and TGF-β1 in patients with AECOPD complicated with mild type Ⅱ respiratory failure impact of index level

作　　者：孙金昊[1] 刘晓飞[1] 李香兰[2] 张秀敏[2] 张春艳[2] SUN Jin-hao;LIU Xiao-fei;LI Xiang-lan(Department of Tuberculosis,Hebei Chest Hospital,Shijiazhuang Hebei 050000,China;Department of Emergency,Hebei Chest Hospital,Shijiazhuang Hebei 050000,China)

机构地区：[1]河北省胸科医院结核科,河北石家庄050000 [2]河北省胸科医院急诊科,河北石家庄050000

出　　处：《临床和实验医学杂志》2022年第11期1148-1152,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究计划项目(编号:20210182)。

摘　　要：目的探究经鼻高流量氧疗治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并轻度Ⅱ型呼吸衰竭对患者血气分析指标及结缔组织生长因子(CTGF)、内皮素-1(ET-1)、转化生长因子β1(TGF-β1)指标水平的影响。方法回顾性择取2019年4月至2021年9月河北省胸科医院收治的AECOPD合并轻度Ⅱ型呼吸衰竭患者120例,根据治疗方案不同将其分为对照组(n=60)、观察组(n=60),其中对照组接受无创正压通气治疗,观察组则接受经鼻高流量氧疗治疗。比较两组治疗后患者血气分析指标[动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、动脉二氧化碳分压(PaCO_(2))、氧合指数(OI)]、CTGF、ET-1、TGF-β1指标水平、肺功能[第一秒钟用力呼气容积(FEV1)、呼气峰值流速(PEF)、用力肺活量(FVC)]恢复情况、并发症发生率、住院时间、气管插管率。结果治疗后,观察组PaO_(2)、SaO_(2)、OI指标水平为(88.41±9.68)mmHg、(96.08±4.55)%、(387.45±17.36)mmHg,均较对照组[(70.11±7.90)mmHg、(83.44±4.06)%、(301.82±13.87)mmHg]升高,PaCO_(2)为(38.49±5.11)mmHg,较对照组[(50.42±6.09)mmHg]低,差异均有统计学意义(P<0.05)。治疗后,观察组CTGF、TGF-β1、ET-1指标水平为(164.11±15.34)μg/mL、(46.01±8.11)pg/mL、(52.71±4.50)pg/mL,均较对照组[(180.36±20.16)μg/mL、(52.69±10.25)pg/mL、(67.86±6.49)pg/mL]降低,差异均有统计学意义(P<0.05)。治疗后,观察组FEV1、PEF、FVC肺功能指标水平为(3.01±0.69)L、(4.34±0.80)L、(6.60±0.75)L/s,均较对照组[(2.53±0.62)L、(3.61±0.73)L、(5.49±0.62)L/s]升高,差异均有统计学意义(P<0.05)。观察组治疗后面部压疮、腹胀、鼻出血、痰堵、喉部不适等并发症发生率为8.33%,较对照组(23.33%)低,差异有统计学意义(P<0.05)。治疗后,观察组住院时间为(18.19±1.46)d,明显较对照组[(22.37±2.02)d]短,且气管插管率占比为1.67%,明显较对照组(15.00%)低,差异均有统计学意义(P<0.05)。结论经鼻高流量氧疗治�Objective To explore the effects of transnasal high flow oxygen therapy on blood gas analysis indexes,connective tissue growth factor(CTGF),endothelin-1(ET-1),transforming growth factor beta 1(TGF-β1)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with mild type Ⅱ respiratory failure.Impact of index level.Methods A total of 120 patients with AECOPD complicated with mild type Ⅱ respiratory failure treated in Hebei Chest Hospital from April 2019 to September 2021 were selected for retrospectively study.According to the treatment scheme,all patients were divided into control group(n=60)and observation group(n=60).The control group received noninvasive positive pressure ventilation and the observation group received transnasal Hyperflow oxygen therapy.The blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),oxygenation index(OI)],CTGF,ET-1 and TGF-β1 index level of the two groups were compared,recovery of pulmonary function[forced expiratory volume in the first second(FEV1),peak expiratory flow(PEF),forced vital capacity(FVC)],incidence of complications,length of hospital stay and endotracheal intubation rate.Results After treatment,the index levels of PaO_(2),SaO_(2) and OI in the observation group were(88.41±9.68)mmHg,(96.08±4.55)%,(387.45±17.36)mmHg,which were higher than those in the control group[(70.11±7.90)mmHg,(83.44±4.06)%and(301.82±13.87)mmHg],and PaCO_(2) was(38.49±5.11)mmHg,which was lower than that in the control group[(50.42±6.09)mmHg],and the differences were statistically significant(P<0.05).After treatment,the index levels of CTGF,TGF-β1 and ET-1 in the observation group were(164.11±15.34)μg/mL,(46.01±8.11)pg/mL,and(52.71±4.50)pg/mL,which were lower than those in the control group[(180.36±20.16)μg/mL,(52.69±10.25)pg/mL,(67.86±6.49)pg/mL],the differences were statistically significant(P<0.05).After treatment,the levels of FEV1,PEF

关 键 词：AECOPD Ⅱ型呼吸衰竭 经鼻高流量氧疗 无创正压通气 血气分析指标 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]