无创正压通气对AECOPD并发呼吸衰竭患者血清KL-6、CC16及和肽素水平的影响

Effects of Noninvasive Positive Pressure Ventilation on Levels of Serum KL-6,CC16 and Copeptin in Patients with AECOPD Complicated with Respiratory Failure

目的研究无创正压通气对AECOPD并发呼吸衰竭患者血清KL-6、CC16及和肽素水平的影响,为临床治疗AECOPD提供指导。方法将2015年10月至2016年10月期间在我院治疗的96例AECOPD并发呼吸衰竭患者按随机数字表法将患者分为对照组和观察组,各48例。两组患者均事先进行祛痰、抗感染等常规治疗方案。观察组患者使用呼吸机利用无创正压通气方式在优先保证患者舒适的状态下进行治疗,对照组患者则进行鼻导管通气治疗,记录患者治疗前后血气参数,及比较两组患者治疗前后KL-6、CC16及和肽素水平。结果两组患者治疗后观察组临床治疗有效率为87.5%,对照组为62.5%,观察组临床疗效明显优于对照组(P<0.05);治疗前两组患者呼吸频率、血气参数、KL-6、CC15及和肽素水平等差异无统计学意义(P>0.05);经NIPPV治疗24h后两组患者的呼吸频率、血气参数等有明显改善,差异具有统计学意义(P<0.05),但观察组参数明显优于对照组(P<0.05);经治疗后患者的KL-6、CC16及和肽素水平有明显下降(P<0.05),观察组患者的下降程度更为显著(P<0.05),差异具有统计学意义。结论采用无创正压通气治疗AECOPD并发呼吸衰竭患者,可明显降低血清KL-6、CC16及和肽素水平,缓解肺部损伤,明显改善患者病情,值得在临床推广和应用。

Objective To study the effects of noninvasive positive pressure ventilation on the levels of serum KL-6, CC16 and peptide in patients with AECOPD complicated with respiratory failure, so as to provide guidance for clinical treatment of AECOPD.Methods 96 patients with AECOPD complicated with respiratory failure treated in our hospital during Oct.2015 ～ Oct.2016 were randomly divided into control group and observation group, and each with 48 cases.Two groups of patients were carried out expectorant and anti-infection therapy before.Patients in the observation group were treated with ventilator in the method of NIPPV and ensured a comfort environment, while the control group were treated with nasal catheter ventilation.The blood gas parameters were recorded, and compared the KL-6, CC16 and peptide levels of two groups before and after treatment.Results After treatment, the clinical effective rates of the observation group and control group were 87.5% and 62.5%, respectively.The clinical efficacy of the observation group was significantly better than that of the control group （P〈0.05）;the respiratory rates, blood gas parameters, KL-6, CC15 and peptide levels had no significant difference between the two groups before treatment （P〉0.05）;after 24h of NIPPV treatment, two groups of patients with respiratory rates and blood gas parameters were significantly improved, the difference was statistically significant （P〈0.05）, but the observation group was significantly better than the parameters the control group （P〈0.05）;after the treatment, the KL-6, CC16 and peptide levels of patient decreased significantly （P〈0.05）, the decrease of observation group patients was more significant （P〈0.05）, and the difference was statistically significant.Conclusion The use of noninvasive positive pressure ventilation in the treatment of patients with AECOPD complicated with respiratory failure can significantly decrease the serum KL-6, CC16 and copeptin levels, alleviate pulmonary injury and improve the patient′s condition.It is worth popularizing in clinical application.