长期无创正压通气对降低慢性肺心病肺动脉压力、肺功能及炎性因子变化的影响

Effects of long-term noninvasive positive pressure ventilation on reducing pulmonary artery pressure,pulmonary function and inflammatory factors in patients with chronic cor pulmonale

目的探讨长期无创正压通气对降低慢性肺心病肺动脉压力、肺功能及炎性因子变化的影响。方法选取收治的80例慢性肺心病患者为研究对象,按照随机数字法分为两组,每组40例。对照组采用常规治疗2周。观察组在此治疗基础上加用无创正压通气。治疗前以及治疗后1周、治疗后2周观察肺动脉压力变化。结果对照组治疗前与治疗后1周及2周、治疗后1周与2周肺动脉压变化比较,P均<0.0005。观察组治疗前与治疗后1周及2周、治疗后1周与2周肺动脉压变化比较,P均<0.0005。两组治疗前肺动脉压变化比较,P>0.05;两组治疗后1周及2周肺动脉压变化比较,P均<0.0005。对照组治疗前后白介素-6、肿瘤坏死因子-α、C-反应蛋白水平的变化,P均<0.0005。对照组治疗前后白介素-8水平的变化,P>0.05。观察组治疗前后白介素-6、肿瘤坏死因子-α、C-反应蛋白水平的变化,P均<0.0005。观察组治疗前后白介素-8水平的变化,P>0.05。两组治疗前后白介素-6、白介素-8、肿瘤坏死因子-α、C-反应蛋白水平的变化,P均<0.0005。对照组治疗前后肺功能FVC、FEV1、FEV1/FVC变化比较,P均>0.05。观察组治疗前后肺功能FVC、FEV1、FEV1/FVC变化比较,P均<0.0005。两组治疗前后肺功能FVC、FEV1、FEV1/FVC变化比较,P<0.005。结论长期无创正压通气对降低慢性肺心病肺动脉压力、肺功能及白介素-6、白介素-8、肿瘤坏死因子-α、C-反应蛋白水平变化均有较好的影响。

Objective To investigate the effect of long-term noninvasive positive pressure ventilation on reducing pulmonary artery pressure, pulmonary function and inflammatory factors in patients with chronic cor pulmonale. Methods 80 patients with chronic cor pulmonale were selected and divided into two groups according to the random number method, 40 cases in each group. Patients in the control group received routine treatment for 2 weeks. Patients in the observation group received noninvasive positive pressure ventilation on the basis of the control group. The changes of pulmonary artery pressure were observed before treatment, 1 week after treatment and 2 weeks after treatment. Results In the control group, the changes of pulmonary artery pressure were compared before and after treatment with P〈0.0005, the changes of pulmo- nary artery pressure at 1 week after treatment and 2 weeks after treatment was compared with P〈0.0005. In the observation group, the changes of pulmonary artery pressure were compared before and after treatment with P〈0.0005, the changes of pulmonary artery pressure at 1 week after treatment and 2 weeks after treatment was compared with P〈0.0005. The compari- son of pulmonary artery pressure between the two groups before the treatment were P〉0.05. The comparison of pulmonary artery pressure between the two groups at 1 week after treatment and 2 weeks after treatment were P〈0.0005. The changes of interleukin-6, tumor necrosis factor- α and c-reactive protein levels in the control group before and after treatment were compared with all P〈0.0005. The change of interleukin-8 level in the control group before and after treatment was compared with P〉0.05. The changes of IL-6, TNF- α and C-reactive protein levels in the observation group before and after treatment were compared with all P〈0.0005. The change of interleukin-8 in the observation group before and after treatment was P〉0.05. The changes of IL-6, IL-8, TNF- α and C-reactive protein levels between the two groups before and after treatment were with P〈0.0005. The changes of pulmonary function FVC, FEV1, FEV1/FVC in the control group before and after treatment were with P〉0.05. The changes of pulmonary function FVC, FEV1, FEV1/FVC in the observation group before and after treatment were with P〈0.0005. The changes of pulmonary function FVC, FEV1, FEV1/FVC between the two groups before and after treatment were with P〈0.005. Conclusion Long-term noninvasive positive pressure ventilation can reduce pulmonary artery pressure and has a good effect on lung function and changes of IL-6, IL-8, TNF- α and C-reactive protein levels in chronic cor pulmonale.