布地格福辅助无创呼吸机治疗COPD伴Ⅱ型呼吸衰竭的临床疗效及对血清炎症因子、miR-223、miR-130a水平的影响  

Clinical efficacy of budesonide/glycopyrrolate/formoterol combined with non-invasive ventilation in the treatment of COPD with typeⅡrespiratory failure and its effects on serum inflammatory factors,miR-223,and miR-130a levels

作　　者：邢双丽 郑红[2] 石明霞 赵明娟 XING Shuang-li;ZHENG Hong;SHI Ming-xi;ZHAO Ming-juan(Department of Respiratory and Critical Care Medicine,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.,Jiaozuo 454150,Henan,CHINA;Department of Respiratory and Critical Care Medicine,Jiaozuo People’s Hospital,Jiaozuo 454150,Henan,CHINA)

机构地区：[1]焦作煤业(集团)有限责任公司中央医院呼吸与危重症医学科,河南焦作454150 [2]焦作市人民医院呼吸与危重症医学科,河南焦作454150

出　　处：《海南医学》2025年第8期1087-1091,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20201863)。

摘　　要：目的探究布地格福辅助无创呼吸机治疗慢性阻塞性肺疾病(COPD)伴Ⅱ型呼吸衰竭(RF)患者的临床疗效及对血清炎症因子、微小核糖核酸-223(miR-223)、miR-130a水平的影响。方法选取2022年3月至2023年3月焦作煤业(集团)有限责任公司中央医院呼吸与危重症医学科收治的127例COPD伴Ⅱ型RF患者纳入研究,采用随机数表法分为呼吸机组64例和药物联合组63例。呼吸机组患者采用无创呼吸机治疗,药物联合组患者采用布地格福联合无创呼吸机治疗,均治疗4周。比较两组治疗4周后的临床疗效,以及治疗前后的肺功能[第1秒用力呼气容积(FEV1)/用力肺活量(FVC)、气道压(Paw)、FVC]、炎症因子[C反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)、白细胞介素-17(IL-17)、可溶性髓系细胞触发受体-1(sTREM-1)]、血清miR-223、miR-130a水平,同时比较两组患者治疗期间的不良反应发生情况。结果药物联合组患者的治疗总有效率为92.06%,明显高于呼吸机组的77.78%,差异有统计学意义(P<0.05);治疗后药物联合组患者的FEV1/FVC、FVC水平分别为(65.84±2.07)%、(2.81±0.20)L,明显高于呼吸机组的(62.59±3.35)%、(2.60±0.22)L,Paw水平为(163.92±25.73)%,明显低于呼吸机组的(186.35±28.54)%,差异均有统计学意义(P<0.05);治疗后药物联合组患者的CRP、HMGB1、IL-17、sTREM-1水平分别为(7.25±1.81)mg/L、(4.15±1.28)μg/L、(41.78±9.32)ng/L、(80.52±21.36)ng/L,明显低于呼吸机组的(9.10±2.02)mg/L、(5.07±1.52)μg/L、(50.31±10.26)ng/L、(93.41±25.10)ng/L,差异均有统计学意义(P<0.05);治疗后药物联合组患者的血清miR-223、miR-130a水平分别为1.36±0.35、1.61±0.43,明显低于呼吸机组的1.71±0.38、2.14±0.55,差异均有统计学意义(P<0.05);治疗期间药物联合组患者的不良反应总发生率为11.11%,略高于呼吸机组的7.94%,但差异无统计学意义(P>0.05)。结论布地格福联合无创呼吸机治疗COPD伴Ⅱ型RF患者能抑制炎Objective To investigate the clinical efficacy of budesonide/glycopyrrolate/formoterol(budesonide/glycopyrrolate/formoterol,BGF)combined with non-invasive ventilation in the treatment of chronic obstructive pulmo-nary disease(COPD)with typeⅡrespiratory failure(RF)and its effects on serum inflammatory factors,microRNA-223(miR-223),and miR-130a levels.Methods A total of 127 COPD patients with typeⅡRF admitted to the Department of Respiratory and Critical Care Medicine,Central Hospital of Jiaozuo Coal Industry(Group)Co.,Ltd.from March 2022 to March 2023 were enrolled in the study.They were randomly divided into a ventilation group(64 cases)and a drug com-bination group(63 cases)using a random number table.The ventilation group received non-invasive ventilation therapy,while the drug combination group received BGF combined with non-invasive ventilation therapy.Both groups of patients were treated for 4 weeks.The clinical efficacy after 4 weeks of treatment,lung function parameters(forced expiratory vol-ume in 1 second[FEV1]/forced vital capacity[FVC],airway pressure[Paw],FVC),inflammatory factors(C-reactive pro-tein[CRP],high mobility group box 1[HMGB1],interleukin-17[IL-17],soluble triggering receptor expressed on my-eloid cells-1[sTREM-1]),serum miR-223 and miR-130a levels before and after treatment,and the incidence of ad-verse reactions during treatment were compared between the two groups.Results The total effective rate in the drug combination group was 92.06%,significantly higher than 77.78%in the ventilation group(P<0.05).After treatment,the FEV1/FVC and FVC levels in the drug combination group were(65.84±2.07)%and(2.81±0.20)L,respectively,signifi-cantly higher than(62.59±3.35)%and(2.60±0.22)L in the ventilation group,while the Paw level was(163.92±25.73)%,significantly lower than(186.35±28.54)%in the ventilation group(P<0.05).The levels of CRP,HMGB1,IL-17,and sTREM-1 in the drug combination group after treatment were(7.25±1.81)mg/L,(4.15±1.28)μg/L,(41.78±9.32)ng/L,and(80.52±21.36)ng/L,respecti

关 键 词：慢性阻塞性肺疾病 Ⅱ型呼吸衰竭 布地格福 无创呼吸机 肺功能 炎症 疗效 

分 类 号：R563[医药卫生—呼吸系统]