雾化吸入联合NPPV对COPD合并呼吸衰竭患者营养状况及CC16、SP-D表达的影响

Effect of Atomizing Inhalation Combined with NPPV on the Nutrition Status and Expressions of CC16 and SP-D of Patients with COPD and Respiratory Failure

目的探讨雾化吸入联合无创正压机械通气(NPPV)对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者营养状况及肺表面活性蛋白D(SP-D)、Clara细胞蛋白(CC16)水平影响性。方法 2013年8月—2016年5月收治的84例COPD合并呼吸衰竭患者,根据其治疗方法分成两组,对照组(42例)常规治疗,研究组(42例)加用雾化吸入联合NPPV治疗,观察不同方法治疗后氧分压(Pa O2)、二氧化碳分压(Pa CO2)、第1秒用力呼吸容积(FEV1)含量水平变化、营养状况[转铁蛋白(TRF)、总蛋白(STP)、白蛋白]和CC16、SP-D表达等指标变化情况。结果对照组排痰困难、口干咽痛发生率分别为28.57%、30.95%,研究组相对应分别为4.76%、4.76%,两组比较差异有统计学意义(P<0.05);对照组治疗后Pa O2、FEV1、Pa CO2分别为:(62.34±10.34)mm Hg、(51.34±2.55)mm Hg、(1.22±0.41)%,研究组分别为:(70.12±11.34)mm Hg、(44.56±1.67)mm Hg、(1.53±0.44)%,研究组上述指标改善幅度明显高于对照组(P<0.05);对照组治疗前后TRF、STP、ALB、CC16、SP-D含量水平无显著变化(P>0.05),研究组治疗后TRF、STP、ALB、CC16较治疗前显著升高,SP-D含量显著下降(P<0.05),研究组治疗后以上水平显著优于对照组(P<0.05)。结论雾化吸入联合NPPV能改善COPD合并呼吸衰竭营养状况和CC16、SP-D含量水平,提高肺功能,改善排痰困难和口干咽痛症状。

Objective To study the effect of atomizing inhalation combined with NPPV on the nutrition status and expressions of CC16 and SP-D of patients with COPD and respiratory failure.Methods 84 cases of patients with COPD and respiratory failure admitted and treated in our hospital from August 2013 to May 2016 were selected and divided into two groups with 42 cases in each,the control group adopted the routine treatment,while the research group adopted the atomizing inhalation combined with NPPV,and the changes of PaO2,PaCO2,FEV1 content level at 1 s,TRF,STP,albumin,CC16 and SP-D were observed.Results The incidence rates of difficulty in expectoration and pharyngalgia in the control group and in the research group were respectively 28.57%,30.95%and 4.76%,4.76%,and the differ-ences were obvious(P<0.05),after treatment,the PaO2,FEV1,PaCO2 in the control group and in the research group were respectively(62.34±10.34)mmHg,(51.34±2.55)mmHg,(1.22±0.41)%and(70.12±11.34)mmHg,(44.56±1.67)mmHg,(1.53±0.44)%,and the improvement degree in the research group was obviously higher than that in the control group,(P<0.05),and there were no obvious changes of TRF,STP,ALB,CC16,SP-D contents before and after treatment(P>0.05),after treatment,the TRF,STP,ALB,CC16 in the research group obviously increased compared with those before treatment,and the SP-D content obviously decreased(P<0.05),after treatment,the levels after treatment were obviously better than those in the control group(P<0.05).Conclusion Atomizing inhalation combined with NPPV can improve the nutrition status and content levels of CC16 and SP-D of patients with COPD and respiratory failure and improve the lung function and difficulty in expectoration and pharyngalgia.