BiPAP对AECOPD并Ⅱ型呼吸衰竭患者气道炎症反应、血气及预后的影响  

Effect of BiPAP on airway inflammatory response,blood gas and prognosis in patients with AECOPD and type II respiratory failure

作　　者：熊云 Xiong Yun(Department of Internal Medicine,Fengxin People's Hospital,Yichun 330700,Jiangxi,China)

机构地区：[1]奉新县人民医院内科,江西宜春330700

出　　处：《四川生理科学杂志》2025年第4期803-805,925,共4页

摘　　要：目的:探讨双水平无创正压通气(Bi level non-invasive positive pressure ventilation,BiPAP)对慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)并Ⅱ型呼吸衰竭患者气道炎症反应、血气及预后的影响。方法:纳入的320例AECOPD并发Ⅱ型呼吸衰竭患者选自于本院2020年1月至2024年12月期间所收治,均实施常规治疗联合BiPAP治疗,对比患者治疗前后血清细胞炎性因子、血气指标;并统计患者治疗后气管插管率,分析其影响因素。结果:与治疗前比较,患者治疗后7 d血清白介素-6(Interleukin-6,IL-6)、超敏-C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)水平均显著下降(P<0.05);与治疗前比较,患者动脉血氧分压(Arterial partial pressure of oxygen,PaO_(2))、酸碱度(PH value,PH)均升高,二氧化碳分压(PaCO_(2))均下降(P<0.05);患者气管插管率为7.81%(25/320);治疗前血清IL-6、hs-CRP、PaCO_(2)水平升高,PaO_(2)水平下降是患者治疗后气管插管的独立危险因素(P<0.05)。结论:AECOPD并发Ⅱ型呼吸衰竭患者应用BiPAP治疗,可减少炎症反应的发生,改善血气指标,治疗前血清IL-6、hs-CRP、PaCO_(2)水平升高,PaO_(2)水平下降是患者治疗后气管插管的危险因素。Objective:To investigate the effect of noninvasive ventilation using bi-level positive airway pressure(BiPAP)on airway inflammatory response,blood gas and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and type II respiratory failure.Methods:From January 2020 to December 2024,320 patients with AECOPD and type II respiratory failure who underwent conventional treatment combined with BiPAP were selected as study subjects.Serum inflammatory factors and blood gas indicators before and after treatment were compared.The tracheal intubation rate after treatment was calculated and its influencing factors were analyzed.Results:On day 7 after treatment,serum interleukin-6(IL-6)and Hypersensitive C-reactive protein(hs-CRP)levels were significantly lower than those before treatment(P<0.05).Compared with before treatment,the patient's arterial partial pressure of oxygen(PaO_(2))and pH increased,while the partial pressure of carbon dioxide(PaCO_(2))decreased(P<0.05).The tracheal intubation rate was 7.81%(25/320).Elevated serum IL-6 and hs-CRP levels and PaCO_(2) before treatment,and decreased PaO_(2) were independent risk factors for tracheal intubation after treatment(P<0.05).Conclusion:BiPAP can reduce the occurrence of inflammatory response improve blood gas indicators in patients with AECOPD and type II respiratory failure.Elevated serum IL-6 and hs-CRP levels and PaCO_(2) before treatment and decreased PaO_(2) are risk factor for tracheal intubation after treatment.

关 键 词：慢性阻塞性肺疾病急性加重期 Ⅱ型呼吸衰竭 炎性因子 血气指标 气管插管率 影响因素 

分 类 号：R563[医药卫生—呼吸系统]