布地奈德联合无创机械通气改善慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者炎症、免疫及胸肺顺应性的研究  

Effect of Budesonide Combined with Non-Invasive Ventilation on Inflammation,Immunity and Chest and Lung Compliance in Patients with AECOPD Complicated with TypeⅡRespiratory Failure

作　　者：王梦 徐银凤 罗丽华 党晓锋 WANG Meng;XU Yinfeng;LUO Lihua;DANG Xiaofeng(Dept.of Pharmacy,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Dept.of Respiratory,the First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院药学部,西安710061 [2]西安交通大学第一附属医院呼吸科,西安710061

出　　处：《中国医院用药评价与分析》2023年第8期922-926,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2020年陕西省科学技术研究发展计划项目(No.2020SF-392)。

摘　　要：目的:探讨布地奈德联合无创机械通气对慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者炎症、免疫及胸肺顺应性的影响。方法:选取2020年12月至2022年11月该院收治的AECOPD合并Ⅱ型呼吸衰竭患者264例,根据随机数字表法分为布地奈德组(n=132)和对照组(n=132)。所有患者均接受无创机械通气治疗;布地奈德组患者同时接受布地奈德吸入治疗,1次2 mg,1日3次;两组患者的疗程均为7 d。比较治疗前后布地奈德组与对照组患者炎症、免疫及胸肺顺应性指标水平,比较治疗后两组患者的临床疗效及并发症发病率。结果:布地奈德组患者的总有效率显著高于对照组,差异有统计学意义[90.2%(119/132)vs.65.9%(87/132),χ^(2)=22.626,P<0.001]。治疗后,布地奈德组患者降钙素原(PCT)水平(t=18.128,P<0.001)、可溶性髓细胞触发受体-1(sTREM-1)水平(t=13.903,P<0.001)较对照组显著降低,差异均有统计学意义。布地奈德组患者胸部顺应性(t=19.386,P<0.001)、肺部顺应性(t=10.664,P<0.001)较对照组显著升高,差异均有统计学意义。布地奈德组患者免疫球蛋白A水平(t=8.445,P<0.001)、免疫球蛋白G水平(t=8.713,P<0.001)较对照组显著升高,差异均有统计学意义。布地奈德组患者第1秒用力呼气容积占预计值百分比(FEV_(1)%)(t=12.408,P<0.001)、FEV_(1)/用力肺活量(t=13.196,P<0.001)较对照组显著升高,差异均有统计学意义。结论:布地奈德联合无创机械通气治疗AECOPE合并Ⅱ型呼吸衰竭有较好疗效,可降低患者血清PCT和sTREM-1水平,提高胸肺顺应性,改善体液免疫功能。OBJECTIVE:To probe into the effect of budesonide combined with non-invasive ventilation on inflammation,immunity and chest and lung compliance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡrespiratory failure.METHODS:A total of 264 patients with AECOPD combined with typeⅡrespiratory failure admitted into the hospital from Dec.2020 to Nov.2022 were extracted to be divided into the budesonide group(n=132)and control group(n=132)via the random number table method.All patients received non-invasive mechanical ventilation treatment.The budesonide group received budesonide inhalation,2 mg for once,3 times/day.The course of treatment in both groups was 7 d.The indexes of inflammation,immunity and chest and lung compliance were compared between the budesonide group and control group before and after treatment,and the clinical efficacy and incidence of complications were compared between two groups after treatment.RESULTS:The total effective rate of budesonide group was significantly higher than that of the control group,with statistically significant differences[90.2%(119/132)vs.65.9%(87/132),χ^(2)=22.626,P<0.001].After treatment,procalcitonin(PCT)(t=18.128,P<0.001)and soluble myeloid trigger receptor-1(sTREM-1)(t=13.903,P<0.001)in the budesonide group were significantly lower than those in the control group,with statistically significant differences.The chest compliance(t=19.386,P<0.001)and lung compliance(t=10.664,P<0.001)of the budesonide group were significantly higher than those of the control group,with statistically significant difference.Immunoglobulin A(t=8.445,P<0.001)and immunoglobulin G(t=8.713,P<0.001)in the budesonide group were significantly higher than those in the control group,with statistically significant difference.The FEV_(1)%(t=12.408,P<0.001)and FEV_(1)/forced vital capacity(t=13.196,P<0.001)in the budesonide group were significantly higher than those in the control group,with statistically significant difference.CONCLUSIONS:Budesoni

关 键 词：布地奈德 无创机械通气 呼吸衰竭 慢性阻塞性肺疾病急性加重期 

分 类 号：R977.1[医药卫生—药品]