无创正压通气联合辛伐他汀治疗COPD合并Ⅱ型呼吸衰竭的疗效观察

The efficacy of noninvasive positive pressure ventilation combined with simvastatin for COPD with type Ⅱ respiratory failure

目的探讨无创正压通气（NIPPV）联合辛伐他汀治疗COPD合并Ⅱ型呼吸衰竭的临床效果。方法将106例COPD合并Ⅱ型呼吸衰竭患者随机分为2组，对照组53例给予常规药物综合治疗和NIPPV治疗，观察组53例则在对照组的基础上加用辛伐他汀治疗。并比较两组的临床疗效和血气指标。结果观察组的总有效率为94．34％，对照组为81．13％，两组相比较差异有统计学意义（P〈0．05），两组患者在治疗72h后PH、PaO2明显升高，PaCO2明显降低，观察组的动脉血气分析指标与对照组比较改善更明显（P〈0．05），两组患者治疗12周后FEV1／FVC和FEV1占最大预计值明显改善；观察组的肺功能指标均较对照组改善更明显（P〈0．05）。结论NIPPV联合辛伐他汀治疗COPD合并Ⅱ型呼吸衰竭疗效确切，安全可靠，可明显改善患者的呼吸功能，值得临床大力推广应用。

Objective To investigate the clinical efficacy of noninvasive positive pressure ventilation （ NIPPV ） combined with simvastatin in the treatment of COPD with type Ⅱ respiratory failure. Methods 106 COPD patients with type Ⅱ respiratory failure were randomly divided into two groups. The control group （ 53 patients ） received conventional medical treatment and NIPPY, while the study group （ 53 patients ）received simvastatin in addition to the therapies used in the control group. The clinical efficacy and the results of blood gas analysis were compared between the two groups. Results The total effectiveness rate differed significantly between the study group and the control group （ 94.34% vs. 81.13%, P〈 0.05 ）. PH value and PaO2 were significantly increased and PaCO2 was decreased in the two groups 72 h after treatment. As compared with the control group, the indicators of arterial blood gas analysis were improved significantly in the study group （ P〈 0.05 ）. FEV1/FVC and predicted FEV1% were improved markedly on weeks 12. Indicators of lung function improved more significantly in the study group than in the control group （ P〈 0.05 ）. Conclusions NIPPV combined with simvastatin for COPD with type Ⅱ respiratory failure is efficacious, safe, and reliable. It can significantly improve respiratory function and is worth popularizing clinically.