布地奈德福莫特罗联合低分子肝素钙对慢性阻塞性肺疾病合并呼吸衰竭患者血气分析、肺功能及炎性因子的影响

Effects of budesonide and low molecular weight heparin calcium on blood gas analysis,lung function and inflammatory factors in COPD patients with respiratory failure

目的探讨布地奈德福莫特罗联合低分子肝素钙对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者血气分析、肺功能和炎性因子的影响。方法选择建德市第一人民医院重症医学科2017年12月至2019年12月收治的COPD合并呼吸衰竭患者82例,按照随机数字表法分为观察组41例和对照组41例。两组均给予常规治疗,对照组给予低分子肝素钙治疗,观察组在对照组基础上联合布地奈德福莫特罗治疗。两组疗程均为7 d。比较两组治疗疗效,治疗前后血气分析、肺功能和炎性因子变化。结果观察组总有效率(92.68%)高于对照组(70.73%)(χ^2=6.609,P<0.05);观察组治疗后氧分压[(76.93±3.67)mmHg]高于对照组[(68.32±2.86)mmHg],而二氧化碳分压[(45.46±4.87)mmHg]低于对照组[(57.29±5.26)mmHg](t=11.849、10.567,均P<0.05);观察组治疗后第1秒用力呼气容积[(1.76±0.16)L]和用力肺活量[(2.79±0.16)L]均高于对照组[(1.42±0.12)L和(2.31±0.19)L](t=10.885、12.373,均P<0.05);观察组治疗后血清肿瘤坏死因子α[(16.83±3.45)ng/L]、白细胞介素6[(23.15±5.46)ng/L]和C反应蛋白[(6.87±1.45)mg/L]均低于对照组的(37.49±6.98)ng/L、(47.38±7.19)ng/L和(15.98±2.67)mg/L(t=16.990、17.185、19.199,均P<0.05)。结论布地奈德福莫特罗联合低分子肝素钙对COPD合并呼吸衰竭疗效明显,且可改善患者血气分析和肺功能,并减轻炎性反应。

Objective:To investigate the effect of budesonide and low molecular weight heparin calcium on blood gas analysis,lung function and inflammatory factors in patients with chronic obstructive pulmonary disease(COPD)and respiratory failure in intensive care unit.Methods:From December 2017 to December 2019,82 COPD patients with respiratory failure admitted to the First People's Hospital of Jiande were divided into observation group(41 cases)and control group(41 cases)according the random digital table method.The control group was treated with low molecular weight heparin calcium,and the observation group was treated with budesonide and formoterol on the basis of the control group.The course of treatment in both two groups was 7 days.The therapeutic effect,blood gas analysis,lung function and inflammatory factors were compared before and after treatment.Results:The total effective rate of the observation group(92.68%)was higher than that of the control group(70.73%)(χ^2=6.609,P<0.05).After treatment,the PaO 2 in the observation group[(76.93±3.67)mmHg]was higher than that in the control group[(68.32±2.86)mmHg],while the PaCO 2[(45.46±4.87)mmHg]was lower than that in the control group[(57.29±5.26)mmHg],and the differences were statistically signficant between the two groups(t=11.849,10.567,all P<0.05).The FEV 1[(1.76±0.16)L]and FVC[(2.79±0.16)L]in the observation group were higher than those in the control group[(1.42±0.12)L and(2.31±0.19)L](t=10.885,12.373,all P<0.05).The serum levels of TNF-α[(16.83±3.45)ng/L],IL-6[(23.15±5.46)ng/L]and CRP[(6.87±1.45)mg/L]in the observation group were lower than those in the control group[(37.49±6.98)ng/L,(47.38±7.19)ng/L and(15.98±2.67)mg/L](t=16.990,17.185,19.199,all P<0.05).Conclusion:The combination of budesonide and low molecular weight heparin calcium can improve the blood gas analysis,lung function and inflammatory response in COPD patients with respiratory failure in ICU.