布地奈德和特布他林联合无创机械通气治疗老年慢性阻塞性肺疾病伴呼吸衰竭患者的效果

Effect of Budesonide and Terbutaline combined with noninvasive mechanical ventilation in the treatment of elderly chronic obstructive pulmonary disease patients with respiratory failure

目的探讨布地奈德和特布他林联合无创机械通气治疗老年慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者的效果。方法选取2019年5月—2020年6月于东营鸿港医院住院治疗的112例老年COPD伴呼吸衰竭患者作为研究对象,按治疗方法的不同分为研究组与对照组,各56例。所有患者均接受常规治疗及无创机械通气治疗,研究组在此基础上联合布地奈德、特布他林治疗。两组均连续给药1周,治疗1周为1个疗程。比较两组的临床疗效和治疗前后的血气指标[pH值、动脉血氧饱和度(SaO_(2))]、肺功能指标[第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]、气道重塑指标[气道内径(L)、气道外径(D)、气道壁厚度(T)、气道腔面积(AI)、气道总横截面积(AO)、气道壁面积(WA)]及血清高迁移率族蛋白B1(HMGB1)、腺苷酸环化酶相关蛋白1(CAP1)含量。结果研究组临床治疗总有效率高于对照组(P<0.05)。治疗后,两组pH值、SaO_(2)均高于治疗前(P<0.05),且研究组高于对照组(P<0.05)。治疗后,两组L值高于治疗前(P<0.05),T值、AI值、AO值、WA值均低于治疗前(P<0.05),且研究组L值高于对照组(P<0.05),T值、AI值、AO值、WA值均低于对照组(P<0.05)。治疗后,两组FEV_(1)、FVC、FEV_(1)/FVC均高于治疗前(P<0.05),且研究组高于对照组(P<0.05)。治疗后,两组CAP1高于治疗前(P<0.05),HMGB1低于治疗前(P<0.05),且研究组CAP1高于对照组(P<0.05),HMGB1低于对照组(P<0.05)。结论布地奈德和特布他林联合无创机械通气治疗可提高老年COPD伴呼吸衰竭患者的临床效果,改善患者的血气指标、肺功能及起到重塑作用,且可提升CAP1含量,降低HMGB1含量,并减轻炎症反应。

Objective To explore the effect of Budesonide and Terbutaline combined with noninvasive mechanical ventilation in the treatment of elderly chronic obstructive pulmonary disease(COPD)patients with respiratory failure.Methods One hundred and twelve elderly COPD patients with respiratory failure hospitalized in Honggang Hospital of Dongying from May 2019 to June 2020 were selected as the research objects.They were divided into study group and control group according to different treatment methods,with 56 cases in each group.All patients received routine treatment and noninvasive mechanical ventilation.On this basis,study group was treated with Budesonide and Terbutaline.Both groups were given drugs continuously for one week,and one week of treatment was a course of treatment.Clinical efficacy,blood gas indexes[pH value,arterial oxygen saturation(SaO_(2))],pulmonary function indexes[first second forced expiratory volume(FEV_(1)),forced vital capacity(FVC),FEV_(1)/FVC],airway remodeling indexes[airway inner diameter(L),airway outer diameter(D),airway wall thickness(T),airway cavity area(AI),total airway cross-sectional area(AO),airway wall area(WA)],serum high mobility group protein box 1(HMGB1)and cyclase-associated protein 1(CAP1)levels before and after treatment of two groups were compared.Results Total effective rate of clinical treatment in study group was higher than that in control group(P<0.05).After treatment,pH value and SaO_(2) of two groups were higher than those before treatment(P<0.05),and study group was higher than that control group(P<0.05).After treatment,L value of two groups was higher than that before treatment(P<0.05),T value,AI value,AO value and WA value of two groups were lower than those before treatment(P<0.05),and L value of study were lower than those of control group(P<0.05).After treatment,FEV_(1),FVC and FEV_(1)/FVC in two groups were higher than those before treatment(P<0.05),and study group was higher than that control group(P<0.05).After treatment,CAP1 in two groups was higher than that before treatment(P<0.05),HMGB1 in two groups was lower than that before treatment(P<0.05),CAP1 in study group was higher than that in control group(P<0.05),and HMGB1 in study group was lower than that in control group(P<0.05).Conclusion Budesonide and Terbutaline combined with noninvasive mechanical ventilation can improve clinical effect of elderly COPD patients with respiratory failure,improve the blood gas index,lung function and remodeling,increase the content of CAP1,reduce the content of HMGB1,and reduce the inflammatory response.