无创正压通气对COPD合并呼吸衰竭患者的临床疗效及其对血清炎症因子和肺功能的影响

Clinical Efficacy of Non-invasive Positive Pressure Ventilation in Patients with COPD Complicated with Respiratory Failure and Its Effects on Serum Inflammatory Factors and Pulmonary Function

目的:探讨无创正压通气(NIPPV)对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的临床疗效及其对血清炎症因子与肺功能的影响。方法:选取2016年1月-2019年1月本院COPD合并呼吸衰竭患者98例,按照随机数字表法分为对照组和治疗组,每组49例。对照组接受常规治疗,治疗组在对照组基础上给予NIPPV治疗。比较两组临床疗效、血清炎性因子、肺功能、生命体征及动脉血气分析情况。结果:治疗组治疗总有效率高于对照组(P<0.05)。治疗组血清超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素-17(IL-17)、血管内皮生长因子(VEGF)水平均低于对照组(P<0.05)。治疗组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、每分钟最大通气量(MVV)及第1秒用力呼气容积/用力肺活量(FEV1/FVC)均高于对照组(P<0.05)。治疗组呼吸(R)、动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO2)及血氧饱和度(SaO2)均优于对照组(P<0.05)。结论:NIPPV治疗COPD合并呼吸衰竭患者可提高治疗效果,改善肺功能,降低血清炎性因子,有效缓解临床症状体征,值得推广。

Objective:To investigate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure and its effects on serum inflammatory factors and pulmonary function.Method:A total of 98 patients with COPD complicated with respiratory failure in our hospital from January 2016 to January 2019 were selected.According to the random number table method,they were divided into the control group and the treatment group,49 cases in each group.The control group was treated with routine treatment.The treatment group was treated with NIPPV treatment on the basis of the control group.Clinical efficacy,serum inflammatory factors,pulmonary function,vital signs and arterial blood gas analysis were compared between the two groups.Result:The total effective rate of the treatment group was higher than that of the control group(P<0.05).The levels of serum hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),interleukin-17(IL-17)and vascular endothelial growth factor(VEGF)in the treatment group were lower than those in the control group(P<0.05).Forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximum ventilatory volume(MVV)and forced expiratory volume/forced vital capacity in the first second(FEV1/FVC)in the treatment group were higher than those in the control group(P<0.05).The respiratory(R),arterial oxygen partial pressure(PaO2),arterial carbon dioxide partial pressure(PaCO2)and blood oxygen saturation(SaO2)of the treatment group were better than those of the control group(P<0.05).Conclusion:NIPPV in treatment of COPD patients with respiratory failure can improve the treatment effect,improve pulmonary function,reduce serum inflammatory factors and effectively relieve clinical symptoms and signs,which is worthy of promotion.