无创正压通气治疗对COPD稳定期患者疗效及炎症因子影响研究

Study on the effects of non-invasive positive pressure ventilation on curative effects in patients during stable period of COPD and inflammatory factors

目的探讨无创正压通气(non-invasive positive pressure ventilation,NIPPV)呼吸机治疗慢性阻塞性肺疾病(COPD)稳定期患者的疗效。方法选择61例处于稳定期的COPD患者,随机分为观察组及对照组,对照组给予稳定期治疗用药及基础用药治疗,而观察组给予每晚不少于4 h的Bi PAP呼吸机治疗。分别于治疗后1、3、6、12个月时观察患者的IL-6、肺功能及CAT评分变化。结果 NIPPV治疗的观察组患者炎症因子IL-6减少,由治疗前(319.1±78.5)ng/L降至12个月后的(148.4±43.4)ng/L。肺功能恶化程度延缓由治疗前的(66.1±16.7)%,缓慢降至12个月后的(60.6±17.0)%;气喘症状改善明显,CAT评分由治疗前的(26.9±7.2)下降至12个月后的(18.8±6.4),与对照组比较差异有统计学意义(P<0.05)。结论 NIPPV治疗可改善COPD稳定期患者体内慢性炎症,同时可以延缓肺功能恶化程度,甚至使部分患者肺功能改善。

Objective To explore the curative effects of non-invasive positive pressure ventilation （NIPPV） respirator in the treatment of patients during stable period of chronic obstructive pulmonary disease （COPD）. Methods A total of 61 patients in stable period of COPD were randomly assigned to the observation group and the control group. The control group was given the medicine for stable period and the medicine for regular treatment, while the observation group was given the therapy of BiPAP respirator every evening for at least 4 hours. Changes of IL-6, pulmonary function and CAT scores 1, 3, 6, and 12 months after the treatment were observed in the patients. Results IL-6 was reduced in the patients in observation group treated by NIPPV, decreasing from（319.1±78.5）ng/L before the treatment to （148.4±43.4）ng/L 12 months after the treatment. The exacerbation degree of pulmonary function was postponed, decreasing from （66.1± 16.7）% before the treatment to （60.6±17.0）% 12 months after the treatment; asthma was improved significantly, and CAT score was reduced from （26.9±7.2） before the treatment to （18.8±6.4） 12 months after the treatment. All the data were statistically significant compared to those in the control group （P〈0.05）. Conclusion NIPPV therapy is able to improve the chronic inflammation in the patients during the stable period of COPD, and meanwhile postpone the exacerbation degree of pulmonary function, and even improve the pulmonary function of some patients.