1,6-二磷酸果糖治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床疗效观察

Clinical Effect of 1, 6 Fructose Diphosphate on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

目的观察1,6-二磷酸果糖治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭的临床疗效。方法选择2010年8月—2013年8月重庆市长寿区人民医院呼吸内科收治的AECOPD合并呼吸衰竭患者140例,随机分成对照组和治疗组,各70例。对照组患者给予抗感染、止咳化痰、解痉平喘等常规治疗及氨溴素,治疗组患者在对照组治疗基础上加用1,6-二磷酸果糖,两组患者均以14 d为1个疗程。比较两组患者临床疗效、治疗前后血气分析指标〔pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)〕及血液流变学指标(全血高切黏度、全血低切黏度、红细胞比容、血小板聚集率、纤维蛋白原)。结果治疗组患者临床疗效优于对照组(u=-2.040,P=0.041)。治疗前两组患者pH值、PaO2及PaCO2比较,差异无统计学意义(P>0.05);治疗后治疗组患者pH值和PaO2高于对照组,PaCO2低于对照组(P<0.05)。治疗前两组患者全血高切黏度、全血低切黏度、红细胞比容、血小板聚集率及纤维蛋白原比较,差异无统计学意义(P>0.05);治疗后治疗组患者全血高切黏度、全血低切黏度、红细胞比容、血小板聚集率及纤维蛋白原低于对照组(P<0.05)。结论在常规治疗基础上给予1,6-二磷酸果糖治疗AECOPD合并呼吸衰竭的疗效确切,能有效改善患者血液流变学及呼吸衰竭症状。

Objective To observe the clinical effect of 1,6 fructose diphosphate on acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） complicated with respiratory failure. Methods From August 2010 to August 2013,a total of 140 AECOPD patients complicated with respiratory failure were selected in the People＇s Hospital of Changshou District,Chongqing,and they were randomly divided into control group and observation group,each of 70 cases. Patients of were given conventional therapy（ including anti- inflammation,relieving cough and reducing sputum,spasmolysis and preventing asthma）and ambroxol,while patients of observation group were given 1,6 fructose diphosphate based on the therapy of control group,both groups treated for 14 days as a course. Clinical effect, blood- gas analysis index（ including p H, Pa O2,Pa CO2） and hemodynamic index（ including whole high blood viscosity, whole low blood viscosity, hematocrit value, platelet aggregation rate,fibrinogen） before and after treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group（ u =- 2. 040, P = 0. 041）. No statistically significant differences of p H,Pa O2 or Pa CO2 was found between the two groups before treatment（ P〉0. 05）; after treatment,p H and Pa O2 of observation group were statistically higher than those of control group,while Pa CO2 of observation group was statistically significantly lower than that of control group（ P〈0. 05）. No statistically significant differences of whole high blood viscosity,whole low blood viscosity, hematocrit value, platelet aggregation rate or fibrinogen was found between the two groups before treatment（ P〉0. 05）; while above index of observation group were statistically significantly lower than those of control group after treatment（ P〈0. 05）. Conclusion Extra 1,6 fructose diphosphate based on conventional therapy has certain clinical effect on AECOPD complicated with respiratory failure,which can effectively improve the hemorheology and relieve the respiratory failure symptoms.