低分子肝素皮下注射联合无创呼吸机对慢性阻塞性肺疾病急性加重患者外周血Th17/Treg平衡的影响  

The effect of subcutaneous injection of low molecular weight heparin combined with non-invasive ventilation on peripheral blood Th17 Treg balance in AECOPD patients

作　　者：于芳 薛明月 吉飞跃 何婷媚 Yu Fang;Xue Mingyue;Ji Feiyue(Department of Respiratory and Critical Care Medicine,Haian People′s Hospital,Nantong 226600,China)

机构地区：[1]海安市人民医院呼吸与危重症医学科,南通226600

出　　处：《中华保健医学杂志》2024年第3期295-298,共4页Chinese Journal of Health Care and Medicine

基　　金：江苏省南通市市级科技计划(指导性)立项项目(JCZ19015)。

摘　　要：目的 研究低分子肝素皮下注射联合无创呼吸机对慢性阻塞性肺疾病急性加重(AECOPD)患者外周血辅助T细胞17(Th17)/调节性T细胞(Treg)Th17/Treg平衡的影响。方法 选取海安市人民医院2021年1月~2023年1月收治的110例AECOPD患者,按照随机数表法分为观察组(低分子肝素皮下注射联合无创呼吸机治疗,55例)和对照组(无创呼吸机治疗,55例)。比较两组患者治疗效果,比较两组患者治疗前后外周血Th17/Treg,比较两组患者治疗前后肺功能变化,比较两组患者不良反应。结果 治疗后,观察组患者治疗效果显著优于对照组(96.36%vs. 70.91%),差异有统计学意义(χ^(2)=12.064,P<0.05)。治疗后,两组患者Treg水平较治疗前显著上升,Th17、Th17/Treg水平下降,且观察组Treg水平高于对照组,Th17、Th17/Treg水平低于对照组[(3.64±1.12)%vs.(2.89±1.03)%、(2.32±0.52)%vs.(3.44±0.64)%、(0.64±0.11)vs.(1.19±0.42)],差异均有统计学意义(t=3.655、10.073、9.395,P<0.05)。治疗后,两组患者用力肺活量(FVC)、动脉氧分压(PaO2)、第1秒用力呼气量(FEV1)、一氧化碳弥散容积(DLCO)水平显著上升,且观察组FVC、PaO2、FEV1、DLCO水平高于对照组[(2.99±0.76)L vs.(2.35±0.51)L、(84.64±12.38)mmHg vs.(75.36±11.65)mmHg、(2.59±0.52)L vs.(2.11±0.49)L、(73.46±8.64)%vs.(67.85±8.12)%],差异均有统计学意义(t=5.186、4.048、4.982、3.509,P<0.05)。两组不良反应发生率比较(9.09%vs. 5.45%),差异无统计学意义(χ^(2)=0.539,P> 0.05)。结论 低分子肝素皮下注射联合无创呼吸机治疗AECOPD患者效果显著,可有效调节患者Th17/Treg平衡,提高患者肺功能,值得临床应用。Objective To investigate the impact of subcutaneous injection of low molecular weight heparin combined with non-invasive ventilation on the balance of peripheral blood helper T cell 17(Th17)regulatory T cell(Treg)Th17 Treg in patients with acute exacerbation of chronic obstruc-tive pulmonary disease(AECOPD).Methods A total of 110 AECOPD patients admitted to our hospital from January 2021 to January 2023 were selected in the study.They were randomly assigned into either observation group(55 patients treated with subcutaneous injection of low molecular weight heparin combined with non-invasive ventilation)or a control group(55 patients treated with non-invasive ventilation)using a random number table method.The treatment effects of two groups of patients was compared.The peripheral blood Th17 Treg functional indicators,the changes in lung function and the adverse reactions between two groups of patients before and after treatment were als ocompared.Results The treatment efficacy of the observation group(96.36%)was significantly better than that of the control group(70.91%),and the difference was statistically significant(χ^(2)=12.064,P<0.05);Following treatment,the Treg levels in the two groups of patients significantly increased,while the Th17 and Th17 Treg levels decreased.The Treg levels post treatment in the observation group were higher than those in the control group,while the Th17 and Th17 Treg levels were lower than those in the control group,with statistically significant differences(t=10.073,3.655,9.395,P<0.05);After treatment,the levels of forced vital capacity(FVC),arterial oxygen partial pressure(PaO 2),first second forced expiratory volume(FEV1),and carbon monoxide diffusion volume(DLCO)in the two groups of patients significantly increased(P<0.05).After treatment,the levels of FVC,PaO 2,FEV1,and DLCO in the observation group were higher than those in the control group,and the difference was statistically significant(t=5.186,4.048,4.982,3.509,P<0.05);There was no statistically significant difference i

关 键 词：低分子肝素 无创呼吸机 慢性阻塞性肺疾病性加重 肺功能 

分 类 号：R563[医药卫生—呼吸系统]