丹参注射液结合NPPV治疗AECOPD伴Ⅱ型呼吸衰竭的疗效及对PARC/CCL18和SP-D水平的影响

Efficacy of Danshen Injection Combined with NPPV in Treatment of AECOPD with TypeⅡRespiratory Failure and Its Influence on PARC/CCL18 and SP-D Levels

目的分析丹参注射液结合无创正压通气(NPPV)治疗慢性阻塞性肺疾病急性加重(AECOPD)伴Ⅱ型呼吸衰竭的疗效及对血清肺部活化调节趋化因子/CC趋化因子18(PARC/CCL18)和肺表面活性蛋白-D(SP-D)水平的影响。方法回顾性分析2017年4月至2019年4月保定市第一中医院重症医学科收治的AECOPD伴Ⅱ型呼吸衰竭患者的临床资料,选取50例NPPV治疗患者的临床资料作为对照组,同时选取50例采用NPPV+丹参注射液治疗患者的临床资料作为观察组。评估两组患者的临床疗效,比较两组氧化应激反应指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂质(LPO)]、PARS/CCL18和SP-D水平,记录不良反应发生情况。结果观察组总有效率高于对照组[92.0%(46/50)比70.0%(35/50)],且观察组疗效优于对照组(P<0.01)。治疗前后SOD、GSH-Px、LPO、PARS/CCL18及SP-D的主效应差异有统计学意义(P<0.05);不考虑测量时间,两组间SOD、GSH-Px、LPO、PARS/CCL18及SP-D的主效应差异有统计学意义(P<0.05);SOD、GSH-Px、LPO、PARS/CCL18及SP-D的时点间与组间存在交互作用(P<0.05),观察组SOD、GSH-Px高于对照组,LPO、PARS/CCL18及SP-D低于对照组。两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论丹参注射液联合NPPV可提高AECOPD伴Ⅱ型呼吸衰竭患者的疗效、减轻氧化应激反应,降低PARS/CCL18及SP-D水平,发挥肺保护作用。

Objective To analyze the efficacy of Danshen injection combined with noninvasive positive pressure ventilation(NPPV)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with typeⅡrespiratory failure,and its influence on serum levels of pulmonary activation regulated chemokine/CC chemokine 18(PARC/CCL18)and pulmonary surfactant protein-D(SP-D).Methods The clinical data of the patients with AECOPD combined with typeⅡrespiratory failure treated with NPPV in the Department of Intensive Medicine of Baoding First Traditional Chinese Medicine Hospital from Apr.2017 to Apr.2019 were retrospectively analyzed.50 patients treated with NPPV were included as a control group,and the 50 patients treated with NPPV+Danshen injection were included as an observation group.The curative effects of the two groups were evaluated;the indicators of oxidative stress response[superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),lipid peroxide(LPO)],PARC/CCL18 and SP-D levels of the two groups were compared,and the adverse reactions were recorded.Results The total effective rate of the observation group was higher than that of the control group[92.0%(46/50)vs 70.0%(35/50)],and the curative effect of the observation group was better than that of the control group(P<0.01).The main effects of SOD,GSH-Px,LPO,PARS/CCL18 and SP-D before and after treatment were statistically significantly different(P<0.05);regardless of the measurement time,the main effects of SOD,GSH-Px,LPO,PARS/CCL18 and SP-D between the two groups were statistically significant(P<0.05);there were interactions in SOD,GSH-Px,LPO,PARS/CCL18 and SP-D between the time points and groups(P<0.05),and the SOD,GSH-PX in the observation group were higher than those in the control group,LPO,PARS/CCL18 and SP-D were lower than those in the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Danshen injection combined with NPPV can improve the curative effect of AECOPD with typeⅡrespiratory failure,reduce oxidative stress reaction,reduce the levels of PARS/CCL18 and SP-D,and play the role of lung protection.