无创机械通气治疗慢性阻塞性肺疾病的疗效及IGF-Ⅰ、IGF-Ⅱ和组织CB的水平表达

A Study of the Level Expression and Clinical Efficacy of Noninvasive Mechanical Ventilation in the Treatment of Insulin-like Growth Factor Ⅰ,Ⅱ and Cathepsin B in Patients with Chronic Obstructive Pulmonary Disease

目的探讨无创机械通气治疗慢性阻塞性肺疾病患者的临床效果及对患者胰岛素样生长因子(IGF)Ⅰ、Ⅱ和组织蛋白酶B(CB)的水平表达的研究.方法回顾性选取在2014年1月至2017年6月于攀枝花学院附属医院诊治的慢性阻塞性肺疾病患者89例作为研究对象,随机分为对照组43例和研究组46例,其中对照组患者采用常规治疗,研究组在对照组的治疗基础上加用无创机械通气进行治疗,以治疗10 d为观察期,分别对2组患者的肺功能、动脉血气变化的各项指标水平进行检测,并统计临床治疗有效率;同时将患者的IGF-Ⅰ、Ⅱ和CB的含量水平变化进行分析.结果(1)研究组患者的肺功能指标:肺活量VC[(302.72±40.79)m L]、最大呼气流量PEF(421.72±37.59)L/min]、第1秒用力呼气容积FEV1[(83.24±11.65)%]明显高于对照组(P<0.05);(2)研究组患者的动脉血气指标:动脉血氧分压(Pa O2)[(99.24±10.16)mm Hg]、二氧化碳分压(Pa CO2)[(43.32±5.37)mm Hg]、氧合指数(Pa O2/Fi O2)[(281.02±19.74)%]均优于对照组患者的检测水平(P<0.05);(3)研究组患者的临床治疗有效率为93.48%明显高于对照组患者的67.44%(P<0.05);(4)研究组患者的IGF-Ⅰ[(11.47±1.53)μg/L]、IGF-Ⅱ[(28.27±11.49)μg/L]低于对照组患者,而CB[(1.03±0.24)ng/m L]则高于对照组患者(P<0.05).结论无创机械通气有利于明确慢性阻塞性肺疾病患者恢复肺功能,并且能够改变患者的胰岛素样生长因子Ⅰ、Ⅱ和组织蛋白酶B水平的异常表达,临床治疗效果明显.

Objective To investigate the clinical effect of noninvasive mechanical ventilation in the treatment of chronic obstructive pulmonary disease（COPD） and the expression of insulin-like growth factor（IGF） Ⅰ, Ⅱand cathepsin B（CB） in patients.Methods 89 patients with chronic obstructive pulmonary disease from January2014 to June 2017 in the hospital for treatment were retrospectively chosen as the research objects. They were randomly divided into the control group（n = 43） and the study group（n = 46）. The control group was treated with conventional therapy. The study group was treated with noninvasive mechanical ventilation on the basis of the control group. The observation period was 10 days of treatment, the level of the indicators of lung function,arterial blood gas changes of the both groups were detected, and the clinical treatment efficiency was taken for statistics. At the same time, the levels of IGF-Ⅰ, Ⅱ and CB in patients were analyzed.Results（1）The lung function of the study group： the lung function VC [（302.72 ± 40.79） m L], the maximum expiratory flow PEF（421.72 ± 37.59）L/min], and the first expiratory volume FEV1 [（83.24 ± 11.65）%], were significantly higher than that of the control group（P 〈0.05）.（2）The arterial blood gas in the study group： arterial oxygen partial pressure（PaO_2） [（99.24 ± 10.16） mm Hg], partial pressure of carbon dioxide（PaCO_2） [（43.32 ± 5.37） mm Hg],oxygenation index（PaO_2/FiO_2） [（281.02 ± 19.74）% ], were better than the level of detection in the control group（P 〈0.05）.（3）The effective rate of clinical treatment was 93.48% in the study group, which was significantly higher than that in the control group of 67.44%（P 〈0.05）.（4）The IGF-Ⅰ [（11.47 ± 1.53） ug/L] and IGF-Ⅱ [（28.27± 11.49） ug/L] in the study group were lower than those in the control group, while CB [（1.03 ± 0.24） ng/ml]was higher than that of the control group（P 〈0.05）.Conclusions Noninvasive mechanical ventilation is helpful to clear the recovery of lung function in patients with chronic obstructive pulmonary disease,can alter the abnormal expression of insulin-like growth factor I, II and cathepsin B levels in patients, and the clinical treatment effect is significant.