布地奈德雾化吸入配合无创机械通气治疗老年慢性阻塞性肺疾病并发呼吸衰竭的疗效研究  

Efficacy of budesonide respules with non-invasive ventilation in the treatment of respiratory failure complicated by COPD in the elderly

作　　者：张净[1] 谭春婷[2] 王珊[1] 石赟[1] 陈颖[1] Zhang Jing;Tan Chunting;Wang Shan;Shi Yun;Chen Ying(Department of Geriatric Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Respiratory Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院老年医学科,北京100050 [2]首都医科大学附属北京友谊医院呼吸内科,北京100050

出　　处：《中国医刊》2024年第1期41-45,共5页Chinese Journal of Medicine

基　　金：国家自然科学基金青年基金(81601210)。

摘　　要：目的 探究布地奈德雾化吸入配合无创机械通气治疗慢性阻塞性肺疾病(COPD)并发呼吸衰竭的老年患者的临床效果。方法 选取2022年2月至2023年2月首都医科大学附属北京友谊医院收治的82例COPD并发呼吸衰竭的老年患者82例,采用随机数字表法分为对照组和观察组,每组41例。对照组接受无创机械通气治疗,观察组在对照组治疗的基础上给予布地奈德(2 mg/次,2次/d)雾化吸入治疗,两组患者均治疗1周。比较两组治疗前后的肺功能、血气指标、生命体征指标、临床症状评分及血清低氧诱导因子-1α、血清淀粉样蛋白A水平,并比较两组治疗后的临床疗效。结果 治疗1周后,两组患者的肺功能指标(用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积与用力肺活量的比值、呼气峰值流速占正常预计值的百分比和6分钟步行试验距离)、动脉血氧分压、血氧饱和度、pH均高于治疗前,且观察组均高于对照组,差异有统计学意义(P<0.05),而呼吸频率、心率、动脉血二氧化碳分压、血清低氧诱导因子-1α、血清淀粉样蛋白A水平和临床症状评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组临床总有效率为85.37%,明显高于对照组的73.17%,但差异无统计学意义(P>0.05)。结论 布地奈德雾化吸入配合无创机械通气治疗可有效提高COPD并发呼吸衰竭老年患者的肺功能,改善动脉血气、生命体征和临床症状,减轻机体的氧化应激和炎症反应,值得临床使用。Objective To investigate the effects of budesonide nebulizer inhalation combined with non-invasive ventilation therapy on serum hypoxia inducible factor-1α(HIF-1α)and serumamyloid A(SAA)in elderly patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure and their clinical efficacy.Method Eighty-two elderly patients with COPD combined with respiratory failure treated in Beijing Friendship Hospital,Capital Medical University from February 2022 to February 2023 were selected for the study.Forty-one cases each were divided into a control group and an observation group using the random number table method.The control group received non-invasive mechanical ventilation,while the observation group was given budesonide respules(2 mg/time,bid)nebulised inhalation treatment for a total of 1 week.The lung function,blood gas indexes,vital signs indexes and clinical symptom scores were compared between the two groups before and after treatment,the serum HIF-1αand SAA levels before and after treatment and the clinical efficacy after treatment were compared between the two groups.Result After treatment,the pulmonary function indexes(FVC,FEV1,FEV1/FVC,PEF%and walking distance within 6 minutes),arterial blood PaO2 and pH levels of the two groups were significantly increased compared with those before treatment,and the data of observation group were higher than that of control group(P<0.05),while PaCO2,serum HIF-1α,SAA and clinical symptom score were significantly lower than before treatment,and the data of observation group were lower than that of control group(P<0.05).Compared to the control group,the observation group showed a greater change in these indicators and a higher overall clinical efficiency(P>0.05).Conclusion Budesonide respules combined with mechanical ventilation can effectively improve the pulmonary function of elderly patients with COPD complicated with respiratory failure,improve the arterial blood gas,vital signs and clinical symptoms,and reduce the body’s oxidative stres

关 键 词：布地奈德 无创机械通气 慢性阻塞性肺疾病 低氧诱导因子-1Α 血清淀粉样蛋白A 

分 类 号：R563[医药卫生—呼吸系统]