双水平气道正压通气联合舒利迭对COPD合并呼吸衰竭患者呼吸衰竭症状、免疫功能及生活质量的影响

Effect of Bi-Level Positive Airway Pressure Combined with Seretide on Immune Function,Quality of Life and Respiratory Failure Symptoms of Patients with COPD Complicated with Respiratory Failure

目的:探讨双水平气道正压通气(Bi-PAP)联合舒利迭对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者呼吸衰竭症状、免疫功能以及生活质量的影响。方法:按照随机数字表法将2012年6月至2016年12月间我院收治的157例COPD合并Ⅱ型呼吸衰竭患者分为观察组(n=79)和对照组(n=78),对照组患者在平喘、解痉、化痰、抗感染等常规治疗同时联合Bi-PAP治疗,观察组患者在对照组治疗方案的基础上给予舒利迭治疗。比较两组患者治疗前后呼吸衰竭症状、免疫功能以及生活质量改善情况。结果:观察组治疗后有效率为89.87%(71/79),显著高于对照组的73.08%(57/78)(P<0.05)。治疗后两组患者的呼吸、心率、动脉二氧化碳分压较治疗前降低,动脉氧分压较治疗前升高,且观察组患者呼吸、心率、动脉二氧化碳分压低于对照组,动脉氧分压高于对照组(均P<0.05)。治疗后两组患者血清免疫球蛋白M(IgM)、免疫球蛋白G(IgG)以及免疫球蛋白A(IgA)水平均较治疗前明显升高,且观察组患者治疗后的IgM、IgA、IgG水平高于对照组(均P<0.05)。随着时间的推移,两组患者治疗后的圣·乔治医院呼吸问卷(SGRQ)评分逐渐降低,且观察组治疗后3个月、6个月的SGRQ评分均低于对照组(均P<0.05)。结论:Bi-PAP联合舒利迭能明显改善COPD合并Ⅱ型呼吸衰竭患者呼吸衰竭症状,提高机体免疫力和患者的生活质量,临床推广应用价值高。

Objective： To investigate effect ofbi-level positive airway pressure combined with seretide on immune function, quality of life and respiratory failure symptoms of patients with COPD complicated with type Ⅱ respiratory failure. Methods： 157 patients with COPD complicated with type Ⅱ respiratory failure in our hospital from June 2012 to December 2016 were divided into observation group （n=79） and control group （n=78） according to the random number table method, the patients in the control group were treated with routine treatment such as relieving asthma, relieving spasm, resolving phlegm and anti infection, and combined with Bi-PAP treatment, the patients in the observation group were treated with seretide treatment on the basis of the treatment plan in the control group. Respiratory failure symptoms, immune function and quality of life were compared between the two groups before and after treatment. Results： The effective rate of the observation group after treatment was 89.87% （71/79）, which was significantly higher than that of the control group 73.08% （57/78）（P〈0.05）. After treatment, the respiratory rate, heart rate, arterial partial pressure of carbon dioxide in the two groups were lower than before treatment, and the arterial partial pressure of oxygen was higher than before treatment, and the respiratory rate, heart rate and arterial partial pressure of carbon dioxide in the observation group were lower than those in the control group, and the arterial partial pressure of oxygen was higher than that of the control group （all P〈0.05）. After treatment, levels of serum immunoglobulin M （IgM）,immunoglobulin G （IgG） and immunoglobulin A （IgA） of patients in two groups were significantly higher than those before treatment, and the levels of IgM, IgA and IgG in the observation group after treatment were higher than those in the control group （all P〈0. 05）. Over time, the St.George Hospital Respiratory Questionnaire （SGRQ） score in the two groups after treatment was decreased gradually, and the SGRQ scores of the observation group at 3 months and 6 months after treatment were lower than that of the control group （all P〈0.05）. Conclusion： Bi-PAP combined with Seretide can significantly improve the symptoms of respiratory failure in patients with COPD complicated with type Ⅱ respiratory failure, improve immune function and quality of life of patients, clinical application value is high.