无创通气联合参附注射液治疗对重症哮喘合并呼吸衰竭患儿肺功能、免疫功能及PCT、IL-17和CRP的影响

Effects of non-invasive ventilation combined with shenfu injection on lung function,immune function,PCT,IL-17 and CRP in children with severe asthma complicated with respiratory failure

目的:探讨无创通气下参附注射液对重症哮喘合并呼吸衰竭患儿的临床疗效。方法:选取2021年1月―2022年12月医院收治的重症哮喘合并呼吸衰竭患儿60例,随机数字表法分为A组(n=30)和B组(n=30),A组行无创通气治疗,B组在A组基础上行参附注射液治疗。比较两组患儿肺功能指标、免疫功能指标、血清炎性指标及血气指标,并比较两组治疗总有效率。结果:治疗后,两组呼气峰流速(PEF)、最大呼气第一秒呼出的气量容积(FEV1)、用力肺活量(FVC)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)及免疫球蛋白G(IgG)水平较治疗前均升高,且B组PEF、FEV1、FVC、IgA、IgM及IgG水平高于A组;两组血清降钙素原(PCT)、白介素17(IL-17)及C反应蛋白(CRP)水平较治疗前均降低,且B组PCT、IL-17及CRP水平低于A组;两组动脉血氧分压(PaO_(2))较治疗前均升高、动脉血二氧化碳分压(PaCO_(2))较治疗前均降低,且B组PaO_(2)高于A组、PaCO_(2)低于A组;B组治疗总有效率与A组差异无统计学意义;但按照不同的治疗等级进行秩和检验发现,以B组的临床疗效更好,差异有统计学意义。结论:无创通气下参附注射液治疗重症哮喘合并呼吸衰竭,能有效改善患儿肺功能,具有调节免疫功能作用,减轻血清炎症反应,临床疗效较好。

Objective To investigate the clinical effect of Shenfu injection on children with severe asthma and respiratory failure under non-invasive ventilation.Methods Sixty children with severe asthma complicated with respiratory failure admitted to the hospital from January 2021 to December 2022 were randomly divided into group A(n=30)and group B(n=30).Group A received non-invasive ventilation treatment,and group B was treated with injection on the basis of group A.Pulmonary function indexes,immune function indexes,serum inflammatory indexes and blood gas indexes were compared between the two groups,and the total effective rate was compared between the two groups.Results After treatment,the levels of peak expiratory flow rate(PEF),maximum volume of exhaled air in the first second of exhalation(FEV1),forced vital capacity(FVC),immunoglobulin A(IgA),immunoglobulin M(IgM)and immunoglobulin G(IgG)in both groups were increased compared with those before treatment.The levels of PEF,FEV1,FVC,IgA,IgM and IgG in group B were higher than those in group A.Serum levels of procalcitonin(PCT),interleukin17(IL-17)and C-reactive protein(CRP)in 2 groups were lower than before treatment,and the levels of PCT,IL-17 and CRP in group B were lower than those in group A.Arterial partial pressure of oxygen(PaO_(2))increased and arterial partial pressure of carbon dioxide(PaCO_(2))decreased in both groups compared with before treatment,and PaO_(2) in group B was higher than that in group A and PaCO_(2) was lower than that in group A.There was no significant difference in the total effective rate between group B and group A.However,according to the rank sum test of different treatment grades,the clinical efficacy of group B was better,and the difference was statistically significant.Conclusion In the treatment of severe asthma complicated with respiratory failure with non-invasive ventilation,Shenfu injection can effectively improve lung function,regulate immune function,reduce serum inflammatory response,and has a good clinical effect.