噻托溴铵与无创正压通气对老年COPD合并呼吸衰竭患者血气分析、炎症因子及APN、SOD、PAB水平的影响

Effects of thiazide bromide and noninvasive positive pressure ventilation on blood gas analysis, inflammatory factors and APN, SOD and PAB levels in elderly patients with COPD and respiratory failure

目的研究噻托溴铵与无创正压通气对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者血气分析、炎症因子及脂联素(APN)、超氧化物歧化酶(SOD)、前白蛋白(PAB)水平的影响。方法以2017年2月至2018年2月在深圳市人民医院龙华分院呼吸内科收治的老年COPD合并呼吸衰竭患者82例为研究对象。将其按照随机数字表法平均分成试验组和对照组。对照组给予常规治疗以及无创正压通气,试验组则在对照组的基础上给予噻托溴铵治疗,两组均给予为期30d的治疗。分别比较两组治疗前后肺功能指标、血气分析指标、炎症因子以及APN、SOD、PAB水平的变化情况。结果治疗后试验组FVC、FEV1、FEV1/FVC水平相比对照组较高(P值均<0.05)。治疗后试验组PaCO2水平相比对照组较低,而PaO2水平相比对照组较高(P值均<0.05)。治疗后试验组血清IL-8与IL-13水平相比对照组较低(P值均<0.05)。治疗后试验组血清APN、SOD、PAB水平相比对照组较高(P值均<0.05)。结论噻托溴铵与无创正压通气可显著改善老年COPD合并呼吸衰竭患者肺功能以及血气分析,同时有利于减轻炎症反应,提高APN、SOD、PAB水平。

Objective To study and analyze the effects of tiatoxonium bromide and noninvasive positive pressure ventilation on blood gas analysis,inflammatory factors and adiponectin (APN),superoxide dismutase(SOD) and prealbumin (PAB) levels in elderly patients with chronic obstructive pulmonary disease(COPD) and respiratory failure.Methods Eighty-two elderly patients with COPD and respiratory failure admitted to our hospital from February 2017 to February 2018 were studied.They were divided into experimental group and control group according to random number table method.The control group was treated with routine treatment and noninvasive positive pressure ventilation,while the experimental group was treated with thiazide bromide on the basis of the control group,and both groups were treated with 30 days treatment.Lung function indexes,blood gas analysis indexes,inflammatory factors,APN,SOD and PAB levels of the two groups were compared before and after treatment.Results Forced vital capacity(FVC),forced expiratory volume in one second(FEV1) and FEV,/FVC levels in the experimental group after treatment were higher than the control group(all P<0.05).After treatment,the PaCO2 level of the experimental group was lower than the control group,while the PaO2,level was higher than the control group (all P<0.05).Serum IL-8 and IL-13 levels in the experimental group were lower than the control group after treatment(all P<0.05).Serum APN,SOD and PAB levels in theexperimental group after treatment were higher than in the control group (all P<0.05).Conclusions Tiatoxonium bromide and non-invasive positive pressure ventilation can significantly improve lung function and blood gas analysis in elderly patients with COPD and respiratory failure,and also help reduce inflammatory reaction and improve APN.SOD and PAB levels.Which is worthy of clinical promotion and application.