氦氧混合气联合雾化吸入药物治疗重症气道阻塞性肺疾病的临床研究  

The effects of inhailing β_2-agonista and M-antagonist with Heliox-driven in the treatment of severe obstructive airway diseases

作　　者：解立新[1] 李国保[2] 郝凤英[1] 金桂清[1] 刘又宁[1] 

机构地区：[1]解放军总医院呼吸科,100853 [2]新乡市中心医院

出　　处：《河北医药》2003年第4期246-248,共3页Hebei Medical Journal

基　　金：解放军总医院创新课题 (课题编号 :院新 0 1YX0 0 1 )

摘　　要：目的　对氦氧混合气 (79%氦∶2 1%氧 )为驱动气源雾化联合吸入 β2 受体激动剂和 (或 )M 受体损坏抗剂对重症哮喘和慢性阻塞性肺疾病 (COPD)的治疗作用进行探讨。方法　选择病房 8例重症支气管哮喘患者采用自身对照方式 ,观察以氦氧混合气为驱动气源和压缩空气为驱动气源雾化吸入备劳特前后肺肺功能和血气的变化。选择病房慢性阻塞性肺疾病急性发作合并高二氧化碳血症 (PaCO2>5 0mmHg)患者 30例 ,随机分为实验组 (16例 ,以氦氧混合气为驱动气源 )和对照组 (14例 ,以压缩空气为驱动气源 )雾化吸入酚间羟异丙肾上腺素 (备劳特 )和溴化异丙阿托品 (爱全乐 ) ,观察治疗前后动脉血气和肺功能的变化。结果　病房重症哮喘患者以氦氧混合气为驱动气源与以压缩空气为驱动气源疗效比较 ,FVC、FVE1 .0 、FEF50 差异具有显著性 ,血气分析结果示PaO2 差异有显著性。COPD患者试验组与对照组比较 ,治疗后FEV 1.0、PEF差异均具有显著性 ,血气分析结果示试验组患者与对照组比较治疗后PaO2 和PaO2 均有统计学意义 ,试验组患者气指标有显著性改善。结论　氦氧混合联合雾化吸入 β2 受体激动剂和 (或 )M 受体拮抗剂在治疗重症哮喘和COPD方面传统方法比较有明显优势 。Objective To evaluate the effects of a helium oxygen mixture (79% He～21% O 2) as an aerosolizing compressed gas for β 2 agonist and/or M antagonist therapy in patients with severe asthma and COPD.Methods A prospective and single blinded study was performed in the laboratory of respiratory disease.8 patients with severe asthma were enrolled.The patients inhaled berotec with helox driven or compressed air driven in random order.30 patients with acute attack of chronic obstuctive pulmonary disease (COPD) complicated by hypercapnia were enrolled.The patients were randomly divided into experimental group (16 cases)and control group (14 cases).The experimental group inhaled berotec and atrovent with heliox driven,and the control group inhaled berotec and atrovent with compressed air driven.The results of spirometeric paramenters and arterial blood gas analysis were performed.Results In the asthmatic patients,there revealed statistical differences between heliox driven and compressed air driven for FVC,FEV 1.0 ,FEF 50 and PaO 2,and in the COPD patients,there shown significant differences between experimental group and control group for FEV 1.0 ,PEF,PaO 2 and PaCO 2.Conclusion Compared with the traditional way for compressed air driven,the way of inhaling β 2 gaonist and/or M antagonist with heliox driven has obvious superiority for severe asthma and COPD,which might be due to the cooperative effects between inhaling heliox on its physical gas properties and improving delivery of β 2 agonist and M antagonist in the treatment of severe asthma and COPD.

关 键 词：支气管哮喘 重症气道阻塞性肺疾病 氦氧混合气 雾化吸入药物 Β2-受体激动剂 M-受体拮抗剂 

分 类 号：R56[医药卫生—呼吸系统] R974.3[医药卫生—内科学]