布地格福吸入气雾剂联合双水平气道正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的效果评价  

Efficacy evaluation of Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with bilevel positive airway pressure in the treatment of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure

作　　者：谢璟 董鹏 甘语波 何敏 王荣丽 XIE Jing;DONG Peng;GAN Yubo;HE Min;WANG Rongli(Department of Respiratory Medicine,the Sixth People’s Hospital of Yibin,Sichuan,Yibin 644600,China;Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Southwest Medical University,Sichuan,Luzhou 646000,China)

机构地区：[1]四川省宜宾市第六人民医院呼吸内科,四川宜宾644600 [2]西南医科大学附属医院呼吸与危重症医科,四川泸州646000

出　　处：《中国医药科学》2024年第4期14-17,97,共5页China Medicine And Pharmacy

基　　金：四川省宜宾市卫生健康委员会科研课题(2020YW040)。

摘　　要：目的探讨布地格福吸入气雾剂联合双水平气道正压通气(BiPAP)治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的效果,探讨对患者更有益的治疗方案。方法选取2021年9月至2022年8月就诊于宜宾市第六人民医院呼吸内科住院治疗的老年慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者,随机选取80例,使用计算机随机数据生成器将80例患者随机分为BiPAP组(对照组),BiPAP+布地格福吸入气雾剂组(试验组),每组各40例。所有患者均给予常规治疗+BiPAP,试验组患者同时加用布地格福吸入气雾剂吸入治疗,2吸/次,2次/d,连续7 d。分别在治疗前、治疗12 h、治疗24 h及治疗结束时对所有患者测定氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))。分别于治疗前及治疗结束时检测患者第一秒用力呼气量(FEV_(1))、用力肺活量(FVC)、白细胞介素-6(IL-6)以及肿瘤坏死因子-α(TNF-α)水平。结果试验组患者在治疗12、24 h及治疗结束时动脉血PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。试验组患者在治疗24 h及治疗结束时动脉血PaO_(2)高于对照组,差异有统计学意义(P<0.05)。治疗结束时试验组患者肺功能FEV_(1)、FVC高于对照组,差异有统计学意义(P<0.05)。治疗结束时试验组患者血清IL-6、TNF-α低于对照组,差异有统计学意义(P<0.05)。结论布地格福吸入气雾剂联合BiPAP可明显改善慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的肺功能、呼吸困难症状及炎症反应,且治疗作用优于单用BiPAP,推荐临床应用。Objective To explore the curative effect of Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol combined with bilevel positive airway pressure(BiPAP)in the treatment of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure,so as to explore a more beneficial treatment scheme for patients.Methods A total of 80 elderly patients with acute exacerbation of chronic obstructive pulmonary disease complicated with typeⅡrespiratory failure who were hospitalized in the Department of Respiratory Medicine of the Sixth People’s Hospital of Yibin from September 2021 to August 2022 were randomly selected and divided into the BiPAP group(the control group)and the BiPAP+Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol group(the experimental group)by using computer random data generator,with 40 patients in each group.All patients were given routine treatment+BiPAP,and the patients in the experimental group were given Budesonide,Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol therapy on the basis of the above treatment,2 inhalations/time and 2 times/day for 7 days.The partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were measured before treatment,after 12 hours of treatment,after 24 hours of treatment and at the end of treatm ent.The levels of forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured before and at the end of treatment.Results After 12 hours of treatment,after 24 hours of treatment and at the end of treatment,PaCO_(2)in arterial blood of patients in the experimental group was lower than that in the control group,with statistically significant difference(P<0.05).After 24 hours of treatment and at the end of treatment,PaO_(2)in arterial blood of patients in the experimental group was higher than that in the control group,with statistically significant difference(P<0.05).At the end of treatment,FEV_(1

关 键 词：慢性阻塞性肺疾病 双水平正压通气 布地格福 肺功能 白细胞介素-6 肿瘤坏死因子-Α 

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