波生坦片联合无创通气治疗慢性肺心病患者的临床研究

Clinical trial of bosentan tablets combined with non-invasive ventilation in the treatment of patients with chronic cardiopulmonary disease

目的观察波生坦联合无创通气治疗对慢性肺心病患者肺功能、血清和肽素(Copeptin)的影响。方法将102例慢性肺心病患者分为对照组与试验组,每组51例。2组均给予常规对症治疗。在此基础上对照组给予无创通气治疗,每次4 h,每天2次;试验组在对照组的基础上给予波生坦,每次62.5 mg,每天2次,口服。2组均连续治疗14 d。观察2组患者的临床疗效及治疗前后的血气指标变化情况、肺功能指标、血流动力学指标变化情况,检测2组患者治疗前后Copeptin和N末端前体脑钠肽(NT-proBNP)水平,同时观察药物不良反应发生率。结果治疗后,对照组和试验组总有效率分别为74.51%,92.16%,差异有统计学意义(P<0.05)。治疗后,对照组和试验组的平均肺动脉压(mPAP)分别为(28.83±2.75)和(24.56±2.40)mmHg,动脉血氧分压(PaO2)分别为(76.53±7.40)和(85.48±6.27)mmHg,二氧化碳分压(PaCO2)分别为(45.41±8.26)和(38.61±7.49)mmHg,第1秒用力呼气量(FEV1)分别为(1.86±0.44)和(2.14±0.59)L,呼气高峰流量(PEFR)分别为(3.92±0.91)和(4.64±1.15)L·s^-1, Copeptin分别为(1.08±0.27)和(0.75±0.14)ng·mL^-1,NT-proBNP分别为(1.63±0.35)和(1.17±0.22)ng·mL^-1,差异均有统计学意义(均P<0.05)。对照组和试验组的药物不良反应发生率分别为25.49%和9.80%,差异有统计学意义(P<0.05)。结论波生坦联合无创通气治疗慢性肺心病,疗效较好,患者临床症状明显缓解,血气分析指标及心肺功能显著改善。

Objective To investigate the effects of bosentan combined with non-invasive ventilation on pulmonary function,serum Copeptin level in patients with chronic cardiopulmonary disease.Methods A total of 102 patients with chronic cardiopulmonary disease were divided into control group and treatment group,with 51 cases in each group.Two groups were given routine symptomatic treatment.On this basis,control group was treated with non-invasive ventilation,4 h a time,twice a day.Treatment group was treated with bosentan,62.5 mg a time,twice a day.Both groups were treated for 14 d.The clinical efficacy of the two groups were observed.The changes of blood gas index,pulmonary function indicators,hemodynamic indicators,serum Copeptin and N-terminal pro B type natriuretic peptide(NT-proBNP)levels and incidence of adverse drug reactions in two groups were observed.Results After treatment,the total effective rates of control group and treatment group were 74.51%and 92.16%,with significant difference(P<0.05).After treatment,the mean pulmonary arterial pressure(mPAP)of control group and treatment group were(28.83±2.75)and(24.56±2.40)mmHg,arterial blood oxygen pressure(PaO2)were(76.53±7.40)and(85.48±6.27)mmHg,carbon dioxide partial pressure(PaCO2)were(45.41±8.26)and(38.61±7.49)mmHg,forced expiratory volume in one second(FEV1)were(1.86±0.44)and(2.14±0.59)L,peak expiratory flow rates(PEFR)were(3.92±0.91)and(4.64±1.15)L·s^-1,the Copeptin were(1.08±0.27)and(0.75±0.14)ng·mL^-1,and NT-proBNP were(1.63±0.35)and(1.17±0.22)ng·mL^-1,all with significant difference(all P<0.05).The incidence of adverse drug reactions in control group and treatment group were 25.49%and 9.80%,with significant difference(P<0.05).Conclusion Bosentan combined with non-invasive ventilation is effective in the treatment of chronic pulmonary heart disease.The clinical symptoms of the patients are significantly relieved,blood gas analysis indicators and cardiopulmonary function are significantly improved.