孟鲁司特钠与BiPAP对COPD伴呼吸衰竭患者的临床效果分析

Clinical effect of montelukast sodium and BiPAP on COPD patients with respiratory failure

目的分析孟鲁司特钠与双水平无创正压通气（BiPAP）对慢性阻塞性肺疾病（COPD）伴呼吸衰竭患者的临床治疗效果。方法选取2015年8月至2017年5月海口市第四人民医院收治的COPD伴呼吸衰竭患者124例进行回顾性分析，根据治疗方法不同分为对照组和观察组。对照组患者采用常规治疗，观察组在常规治疗基础上给予BiPAP呼吸机＋孟鲁司特钠治疗，分析2组患者治疗效果。结果治疗前，2组患者改良版英国医学研究会呼吸问卷（mMRC）评分、血气分析指标比较，差异无统计学意义；治疗后，观察组患者mMRC评分、动脉血氧分压、动脉血二氧化碳分压及动脉血氧饱和度水平均优于对照组（￡值分别为8．719、3．620、9．426、5．501，P值均〈0．05）。治疗前，2组患者血清、尿液中中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平和血清氨基末端脑钠肽前体（NT-proBNP）、磷脂酶A2（PLA2）、C反应蛋白（CRP）水平比较，差异均无统计学意义；治疗后，观察组患者血清、尿液中NGAL水平和血清NT-proBNP、PI，A2、CRP水平均低于对照组（t值分别为17．708、26．135、20．486、4．544、10．367，P值均〈0．05）。结论孟鲁司特钠与BiPAP治疗COPD伴呼吸衰竭疗效确切，可有效改善患者呼吸困难程度，减轻机体炎症反应和细胞损伤。

Objective To analyze the clinical effect of montelukast sodium and bi-level positive airway pressure （BiPAP） in patients with chronic obstructive pulmonary disease （COPD） and respiratory failure. Methods 124 cases of COPD with respiratory failure treated in Haikou Fourth People＇s Hospital from August 2015 to May 2017 were divided into the control group and the observation group according to the treatment methods. The control group was treated with routine treatment, and the observation group was treated with BiPAP ventilator plus montelukast sodium on the basis of routine treatment. The results of the treatment were analyzed in the two groups. Results There was no statistical difference between the two groups of modified British medical research council （mMRC） and blood gas analysis before the treatment, mMRC and blood gas analysis of the patients in the observation group were treated after treatment. The levels of partial pressure of oxygen, partial pressure of carbon dioxide and oxygen saturation arterial oxygen saturation were higher than those in control group （ t =8. 719,3. 620,9. 426, 5. 501, all P〈0.05）. There was no significant difference between the levels of neutrophils enzyme related lipid carrier protein gelatin （NGAL） in serum and urine, N-terminal pro-brain natriuretic peptide （NT proBNP）, phospholipase A2 （PLA2）, C-reactive protein （CRP） levels before treatment. The level of NGAL in serum and urine, NT-proBNP, PLA2, CRP of patients in the observation group were lower than those in the control group after treatment （t=17. 708, 26.135, 20. 486 , 4. 544,10. 367, all P〈0.05）.Conclusions Montelukast sodium and BiPAP are effective in treating COPD with respiratory failure, which can effectively improve the patients＇ degree of dyspnea, reduce inflammation and cell damage.