NIPPV联合呼吸兴奋剂治疗COPD合并轻度肺性脑病患者对血清学指标的影响

Effect of NIPPV combined with respiratory stimulant therapy on serum markers in COPD patients with mild pulmonary encephalopathy

目的：分析无创正压通气（NIPPV）联合呼吸兴奋剂治疗对慢性阻塞性肺疾病（COPD）合并轻度肺性脑病患者血清学指标的影响。方法：选取2012年11月~2015年2月我院收住的COPD合并轻度肺性脑病患者102例,根据接受的临床治疗方式不同,分为观察组及对照组,各51例。对照组接受单纯呼吸兴奋剂治疗,观察组接受NIPPV联合呼吸兴奋剂治疗,对比两组动脉血气,血清血管紧张素Ⅱ（AngⅡ）、磷酸肌酸激酶（CPK）、乳酸脱氢酶（LDH）、白介素-6（IL-6）、白介素-8（IL-8）、白介素-10（IL-10）水平,S-100β、神经元特异性烯醇酶（NSE）、髓鞘碱性蛋白（MBP）、超氧化物歧化酶总活力（TSOD）、丙二醛（MDA）水平,T3、T4、促甲状腺激素（TSH）水平差异。结果：观察组接受治疗后的pH值、动脉血氧分压（PaO_2）高于对照组,动脉二氧化碳分压（PaCO_2）低于对照组（P〈0.05）;观察组接受治疗后的血清AngⅡ、CPK、LDH、IL-6、IL-8、IL-10水平均低于对照组（P〈0.05）;观察组接受治疗后的血清S-100β、NSE、MBP、MDA水平低于对照组,T-SOD水平高于对照组（P〈0.05）;观察组接受治疗后的血清T3、T4、TSH水平均高于对照组（P〈0.05）。结论：COPD合并轻度肺性脑病患者接受NIPPV联合呼吸兴奋剂治疗,可以有效优化呼吸功能、平衡体液内环境,具有积极的临床意义。

Objective：To analyze the effect of NIPPV with respiratory stimulant therapy on serum markers in COPD patients with mild pulmonary encephalopathy.Methods：A total of 102 cases of COPD patients with mild pulmonary encephalopathy hospitalized in our hospital from November 2012 to February 2015 were selected as research subjects and divided into observation group 51 cases and control group 51 cases according to the different clinical treatment they received.Control group received respiratory stimulant therapy alone,observation group received NIPPV combined with respiratory stimulant therapy,and then differences in arterial blood gas,serum AngⅡ,CPK,LDH,IL-6,IL-8and IL-10 levels,S-100β,NSE,MBP,TSOD and MDA levels as well as T3,T4 and TSH levels were compared between two groups.Results：PH value and PaO_2 value of observation group after treatment were higher than those of control group,and PaCO_2 level was lower than that of control group（P〈0.05）;serum AngⅡ,CPK,LDH,IL-6,IL-8and IL-10 levels of observation group after treatment were lower than those of control group（P〈0.05）;serum S-100β,NSE,MBP and MDA levels of observation group after treatment were lower than those of control group,and T-SOD level was higher than that of control group（P〈0.05）;serum T3,T4 and TSH levels of observation group after treatment were higher than those of control group（P〈0.05）.Conclusions：NIPPV combined with respiratory stimulant therapy for COPD patients with mild pulmonary encephalopathy can effectively optimize respiratory function and equilibrate body fluid environment,and it has active clinical significance.