异丙托溴铵经气道雾化治疗慢阻肺急性加重期疗效及对气道通气功能和血气指标的影响

Effect of airway nebulization with ipratropium bromide in the treatment of AECOPD and the influence on airway ventilation function and blood gas indicators

目的 :探讨于常规经气道氧气雾化吸入治疗基础上添加异丙托溴铵对于慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及对通气功能和血气指标的影响。方法 :选取2018年5月-2021年6月本院收治的AECOPD患者90例,以随机数字表法分为两组,对照组予以常规雾化吸入,观察组予以异丙托溴铵联合常规雾化吸入,对比两组疗效、肺通气功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC]、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、炎性因子水平[降钙素原(PCT)、白介素-6(IL-6)、干扰素-γ(IFN-γ)]及不良反应。结果 :观察组总有效率为93.33%显著高于对照组77.78%;治疗后观察组FVC、FEV_(1)及FEV_(1)/FVC指标水平均高于对照组;治疗后观察组PaO_(2)高于对照组,动脉血PaCO_(2)水平低于对照组;治疗后观察组PCT、IL-6、IFN-γ水平均低于对照组;两组不良反应发生率无显著差异。结论 :异丙托溴铵经气道氧气雾化治疗AECOPD患者效果显著,可使患者肺通气功能、血气指标得到有效改善,降低炎性反应且安全性高。

Objective To investigate the effect of airway nebulization with ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and the influence on ventilation function and blood gas indicators. Methods Ninety patients with AECOPD admitted to the hospital from May 2018 to June 2021 were selected, and divided into two groups by random number table method. The control group was given conventional airway nebulization. On this basis,the observation group was given airway nebulization with ipratropium bromide. Curative effect, pulmonary ventilation function [forced vital capacity(FVC), forced expiratory volume in 1 second(FEV_(1)) and FEV_(1)/FVC], blood gas indexes [arterial partial pressure of oxygen(PaO_(2)) and arterial partial pressure of carbon dioxide(PaCO_(2)) ], inflammatory factors [procalcitonin(PCT),interleukin-6(IL-6) and interferon-gamma(IFN-γ) ], and adverse reactions were compared between the two groups. Results The total response rate in the observation group was 93.33%, significantly higher than 77.78% in the control group. After treatment, FVC, FEV_(1), and FEV_(1)/FVC in the observation group were higher as compared with the control group. PaO_(2) was higher,and PaCO_(2) was lower in the observation group as compared with the control grou. The levels of procalcin(PCT), interleukin-6(IL-6) and interferon-γ(IFN-γ) in the observation group were lower as compared with the control group. The incidence rates of adverse reactions in the two groups were close. Conclusion Airway nebulization with ipratropium bromide is effective in the treatment of AECOPD, which can effectively improve the patient’s pulmonary ventilation function and blood gas indicators, and reduce inflammatory reactions, with high safety.