乙酰半胱氨酸辅助无创呼吸机在老年COPD伴呼吸衰竭患者中的应用价值  

Application Value of Acetylcysteine-Assisted Noninvasive Ventilator in Elderly Patients with COPD and Respiratory Failure

作　　者：李贤明 LI Xianming(Department of Respiratory Medicine,Fujian University of Traditional Chinese Medicine Affiliated Hospital,Fuzhou Fujian 350004)

机构地区：[1]福建中医药大学附属人民医院呼吸科,福建福州350004

出　　处：《医学临床研究》2024年第10期1475-1478,共4页Journal of Clinical Research

摘　　要：【目的】探讨乙酰半胱氨酸辅助无创呼吸机治疗老年慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者的临床疗效。【方法】选取2020年12月至2023年4月在本院诊治的92例老年COPD合并呼吸衰竭患者,按照分层随机抽样法将患者分为对照组和观察组,每组46例。对照组接受无创呼吸机治疗,观察组在对照组基础上加用乙酰半胱氨酸治疗。比较两组呼吸动力学指标[呼吸频率(f)、潮气量(VT)、吸气时间(Ti)/呼吸周期总时间(Ttot)]、血气指标[氧合指数(OI)、血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能指标[呼吸流量峰值(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV 1)]、血清指标[肾上腺髓质素前体中段肽(MRpro-ADM)、生长调节致癌基因α(GRO-α)、白介素-6(IL-6)、C反应蛋白(CRP)]水平、生活质量[圣·乔治呼吸问卷(SGRQ)评分]。【结果】治疗14 d后,观察组f低于对照组,VT、Ti/Ttot高于对照组(P<0.05);观察组OI、SaO_(2)高于对照组,而PaCO_(2)低于对照组(P<0.05);观察组PEF、FVC、FEV 1高于对照组(P<0.05);观察组MRpro-ADM、GRO-α、IL-6、CRP水平低于对照组(P<0.05);观察组SGRQ评分低于对照组(P<0.05)。【结论】乙酰半胱氨酸辅助无创呼吸机治疗老年COPD合并呼吸衰竭患者,可显著改善患者氧合和通气功能,增强肺功能,降低炎症因子水平,提高患者生活质量,是一种有效的治疗方案。【Objective】To investigate the clinical effect of acetylcysteine-assisted noninvasive ventilator in the treatment of elderly patients with chronic obstructive pulmonary disease(COPD)and respiratory failure.【Methods】A total of 92 elderly patients with COPD and respiratory failure diagnosed and treated in our hospital from December 2020 to April 2023 were selected and divided into the control group and the observation group according to stratified random sampling method,with 46 cases in each group.The control group was treated with noninvasive ventilator,and the observation group was treated with acetyl cysteine combined with noninvasive ventilator.The two groups were compared in terms of respiratory dynamics parameters[respiratory rate(f),tidal volume(VT),inspiratory time(Ti)/total respiratory cycle time(Ttot)],blood gas indicators[Oxygenation index(OI),oxygen saturation(SaO_(2)),partial arterial pressure of carbon dioxide(PaCO_(2))],pulmonary function indicators[peak respiratory flow(PEF),forced vital capacity(FVC),forced expiratory volume in the first second(FEV 1)],serum indicators[MRpro-ADM,Growth-regulated oncogeneα(GRO-α),interleukin-6(IL-6),C-reactive protein(CRP)]levels,quality of life[St.George's Respiratory Questionnaire(SGRQ)score].【Results】After 14 days of treatment,f in the observation group was lower than that in the control group,VT and Ti/Ttot were higher than that in the control group(P<0.05).OI and SaO_(2) in observation group were higher than those in the control group,while PaCO_(2) was lower than those in the control group(P<0.05).PEF,FVC and FEV 1 in the observation group were higher than those in the control group(P<0.05).The levels of MRpro-ADM,GRO-α,IL-6 and CRP in the observation group were lower than those in the control group(P<0.05).The SGRQ score of the observation group was lower than that of the control group(P<0.05).【Conclusion】Acetylcysteine-assisted non-invasive ventilator is an effective treatment for elderly patients with COPD complicated with respiratory fail

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 乙酰半胱氨酸 通气机 机械 

分 类 号：R563[医药卫生—呼吸系统]