电子支气管镜灌洗疗法对大叶性肺炎患者临床及实验室指标的影响  

The effect of electronic bronchoscopy lavage therapy on clinical and laboratory indexes in patients with lobar pneumonia

作　　者：李运霞[1] 王志霞 甘少印 罗湘 钟春蕾[1] LI Yun-xia;WANG Zhi-xia;GAN Shao-yin;LUO Xiang;ZHONG Chun-lei(The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第一附属医院,河南新乡453000

出　　处：《实用医院临床杂志》2024年第5期118-122,共5页Practical Journal of Clinical Medicine

基　　金：河南省重点研发与推广专项(科技攻关)(编号:222102310259)。

摘　　要：目的探讨电子支气管镜灌洗疗法对大叶性肺炎患者白细胞介素(IL)-29、嗜酸性粒细胞(EOS)及血清高迁移率族蛋白B-l(HMGBl)水平的影响。方法我院收治的大叶性肺炎患者104例,根据治疗方式不同分为常规组(常规治疗)和灌洗组(常规治疗和电子支气管镜灌洗治疗)各52例,比较两组临床指标,治疗前后肺通气功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、最大呼气中段流量(MMEF)、呼气峰流速(PEF)]、血气指标[血氧饱和度(SaO_(2))、氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))和二氧化碳分压(PaCO_(2))]、IL-29、EOS计数、血清炎症指标[HMGBl、肿瘤坏死因子-α(TNF-α)、IL-6]水平变化,以及安全性评估情况。结果灌洗组症状消失时间和住院时间明显短于常规组(P<0.05);治疗后,两组FVC、FEV_(1)、PEF、MMEF、SaO_(2)、PaO_(2)、PaO_(2)/FiO_(2)均升高,PaCO_(2)均降低(P<0.05);两组鼻咽分泌物及肺泡灌洗液IL-29、EOS计数和血清IL-6、TNF-α、HMGBl均降低,且灌洗组低于常规组(P<0.05);两组不良反应发生情况比较差异无统计学意义(P>0.05)。结论电子支气管镜灌洗治疗可有效改善大叶性肺炎患者临床症状,提高其肺呼吸功能和血氧饱和度,降低其炎症水平,较传统治疗方案更加有效,值得应用。Objective To explore the effect of electronic bronchoscopic lavage therapy on levels of interleukin(IL)-29 and eosinophil(EOS)and serum high mobility group protein B-l(HMGBl)in patients with lobar pneumonia.Methods One hundred and four patients with lobar pneumonia treated in our hospital were selected.The patients were divided into a conventional group and a lavage group according to different treatment methods,52 in each group.The clinical indicators,and pulmonary ventilation function such as forced vital capacity(FVC),forced expiratory volume in one second(FEV 1),maximum mid-expiratory flow(MMEF)and peak expiratory flow(PEF),blood gas indicators such as oxygen saturation(SaO_(2)),partial pressure of oxygen(PaO_(2)),oxygenation index(PaO_(2)/FiO_(2))and partial pressure of carbon dioxide(PaCO_(2)),IL-29,EOS count,serum inflammatory indicators such as HMGBl,tumor necrosis factor-α(TNF-α)and IL-6 as well as safety assessment before and after treatment were compared between the two groups.Results The symptom disappearance time and hospital stay in the lavage group were significantly shorter than those in the conventional group(P<0.05).After treatment,the FVC,FEV 1,PEF,MMEF,SaO_(2),PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly increased(P<0.05)while PaCO_(2)was declined(P<0.05).After treatment,the IL-29 and EOS count in nasopharyngeal secretions and bronchoalveolar lavage fluid and levels of serum IL-6,TNF-αand HMGBl of both groups were decreased(P<0.05),and the indicators in the lavage group were lower compared with those in the conventional group(P<0.05).There was no statistical difference in the occurrence of adverse reactions between the two groups.Conclusions Electronic bronchoscopic lavage therapy can effectively improve the clinical symptoms,enhance the pulmonary respiratory function and blood oxygen saturation,and reduce the inflammation level in patients with lobar pneumonia.It is more effective than traditional treatment regimen.

关 键 词：大叶性肺炎 电子支气管镜灌洗疗法 白细胞介素-29 嗜酸性粒细胞 血清高迁移率族蛋白B-l 

分 类 号：R563.1[医药卫生—呼吸系统]