无创正压通气治疗慢性阻塞性肺疾病并发感染性肺炎的临床效果及对血清MMP-9与TNF-α和IL-8的影响

Clinical effect of noninvasive positive pressure ventilation on treatment of chronic obstructive pulmonary disease complicated with infectious pneumonia and influence on serum MMP-9,TNF-αand IL-8

目的探讨无创正压通气治疗慢性阻塞性肺疾病并发感染性肺炎患者的临床效果及对血清MMP-9、TNF-α和IL-8的影响。方法选取2015年1月-2016年12月医院收治80例慢性阻塞性肺疾病并发感染性肺炎患者作为研究对象,分为研究组和对照组,每组40例。对照组采取常规治疗,研究组在对照组治疗的基础上,实施无创正压通气治疗,两周为一个疗程;完成治疗后,立即对两组患者的临床疗效进行判定,记录临床症状改善时间;进行动脉血血气分析,并测定血清中基质金属蛋白酶-9(MMP-9)、肿瘤坏死因子-α(TNF-α)和白介素-8(IL-8)的含量。结果治疗结束后,研究组临床疗效的总有效率为100.00%,优于对照组(P<0.05);且与对照组相比,研究组患者体温恢复、咳嗽消失、肺部啰音消失及白细胞恢复正常水平的时间均缩短(P<0.05);两组患者的肺功能指标较治疗前均有改善,且研究组改善程度优于对照组(P<0.05);两组患者的血气指标较治疗前均有改善,且研究组患者改善情况优于对照组(P<0.05);血清MMP-9、TNF-α和IL-8的水平均下降,且研究组患者下降情况优于对照组(P<0.05)。结论无创正压通气治疗慢性阻塞性肺疾病并发感染性肺炎的临床效果良好,改善患者的肺功能,降低患者血清中MMP-9、TNF-α和IL-8的水平,值得推广。

OBJECTIVE To explore the clinical effect of noninvasive positive pressure ventilation on treatment of chronic obstructive pulmonary disease（COPD）complicated with infectious pneumonia and influence on serum MMP-9,TNF-αand IL-8.METHODS A total of 80 COPD patients complicated with infectious pneumonia who were treated in the hospital from Jan 2015 to Dec 2016 were recruited as the study objects and divided into the study group and the control group,with 40 cases in each group.The control group was treated with conventional therapy,while the study group was given the noninvasive positive pressure ventilation on basis of the conventional therapy,two weeks as a treatment course.The clinical curative effects were evaluated immediately after the treatment,the time of improvement of clinical symptoms was recorded,the hemogram indexes of arterial blood were analyzed,and the levels of serum matrix metalloproteinase-9（MMP-9）,tumor necrosis factor-α（TNF-α）and interleukin-8（IL-8）were determined.RESULTS The total effective rate of clinical treatment of the study group was100.00%,significantly higher than that of the control group（P〈0.05）.The time of recovery of body temperature,disappearance of cough,disappearance of pulmonary rales and recovery of white blood cells to normal level was significantly shorter in the study group than in the control group（P〈0.05）.The lung function indexes of the two groups of patients were improved more remarkably after the treatment than before the treatment,and the lung function indexes were improved more significantly in the study group than in the control group（P〈0.05）.The blood gas indexes of the two groups of patients were improved more remarkably after the treatment than before the treatment,and the blood gas indexes were improved more significantly in the study group than in the control group（P〈0.05）.The levels of serum MMP-9,TNF-αand IL-8 were reduced,which were reduced more in the study group than in the control group（P〈0.05）.CONCLUSIONThe noninvasive positive pressure ventilation can achieve significantly effect on treatment of COPD complicated with infectious pneumonia,improve the lung function of the patients and reduce the levels of serum MMP-9,TNF-αand IL-8,and it is worthy to be promoted.