雾化吸入碳酸氢钠溶液对AECOPD气道酸化的影响

The therapeutic effect analysis of the jet nebulization treatments with sodium bicarbonate in the acidification of the airway of acute exacerbation chronic obstructive pulmonary diseases

目的观察雾化吸入碳酸氢钠溶液在治疗慢性阻塞性肺疾病急性加重期(AECOPD)气道酸化的临床疗效。方法以64例AECOPD患者为实验对象(重度40例,中度24例)。随机分成实验组和对照组。重度对照组用常规的抗感染、祛痰、常规雾化等治疗;实验组在对照组的基础上加用雾化碳酸氢钠治疗。中度对照组用常规的抗感染、祛痰等治疗;实验组在对照组的基础上加用雾化碳酸氢钠治疗。疗程均为一周。以治疗前后的肺功能、呼出气冷凝液(EBC)中的PH为观察指标。结果 (1)中重度患者实验组EBC中的PH在治疗前后的变化均有统计学意义(重度:7.10±0.502vs7.45±0.29;中度:7.31±0.29vs7.54±0.27,P<0.05),而相应的对照组在治疗前后的变化均没有统计学差异(P>0.05);(2)中重度患者实验组及对照组的肺功能:FEV1/FVC、FEV1/预计值在治疗前后的变化均无统计学意义(P>0.05)。结论雾化碳酸氢钠溶液能有效的改善AECO-PD患者的气道酸化的情况。

Objective To observe the effect of atomization the sodium bicarbonate on the acidification of the airway of patients with the acute exacerbation chronic pulmonary diseases（AECOPD）.Methods 64 patients with AECOPD（40 patients with severe and 24 patients with moderate）were recruited.The subjects were divided randomly into two groups,that is,the experimental group and control group.The control group of severe AECOPD treated with conventional anti-infection,eliminating phlegm and atomization;but the experimental group plused atomization inhalation sodium bicarbonate base on the control group.The control group of moderate AECOPD treated with conventional anti-infection,eliminating phlegm et al.but the experimental group plused atomization inhalation sodium bicarbonate base on the control group.The time of the therapy was one week.We observed the changes of the lung function and The pH values of the EBC before and after treatment from all subjects.Results（1）higher pH values were observed after treatment either in severe patients or in moderate patients of experimental group compared to their control group,and the differences of The pH before and after treatment were statistical significance（severe patients：7.10±0.502 VS 7.45±0.29.moderate patients：7.31±0.29 VS 7.54±0.27.both P0.05）.But the control groups were not statistical significance（both P0.05）.（2）There was not statistical significance in the lung function（forced expiratory volume in one second,FEV1 predicted percent）before and after treatment either the experimental group or the control group of the severe subjects.（P0.05）the same result was found in moderate patients.Conclusion These findings suggest that atomization inhalation sodium bicarbonate improved effectively the airway acidification of the AECOPD patients.