经鼻高流量湿化氧疗治疗AECOPD合并Ⅱ型呼吸衰竭的疗效及对血清HIF-1α和IL-17水平的影响

The curative effect of HHFNC in treating AECOPD with typeⅡrespiratory failure and the effect of that on serum HIF-1αand IL-17 levels

目的:研究分析经鼻高流量湿化氧疗(HHFNC)治疗慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)合并Ⅱ型呼吸衰竭的疗效,以及对血清缺氧诱导因子1α(HIF-1α)、白细胞介素(IL)17水平的影响。方法:选取在医院接受治疗的120例AECOPD合并Ⅱ型呼吸衰竭的患者,根据随机数表法将其分为对照组和观察组,每组60例。两组患者均给予常规基础治疗,对照组患者在此基础上接受经鼻持续正压通气疗法治疗,观察组患者在此基础上接受HHFNC治疗。分析两组患者治疗效果、治疗前后心率(HR)、呼吸频率(RR)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))及血清HIF-1α和IL-17水平变化及不良反应发生情况。结果:观察组患者治疗总有效率明显高于对照组,差异有统计学意义(χ^(2)=7.566,P<0.05);治疗前两组患者HR、RR、PaO_(2)、PaCO_(2)、SaO_(2)、血清HIF-1α及IL-17水平比较差异无统计学意义(P>0.05);治疗3 d后两组患者HR、RR、PaCO_(2)、HIF-1α及IL-17水平均下降,且观察组水平显著低于对照组,差异有统计学意义(t=5.626,t=8.660,t=5.101,t=7.599,t=8.851;P<0.05);治疗3 d后两组患者PaO_(2)、SaO_(2)水平均有所上升,且观察组水平显著高于对照组,差异有统计学意义(t=10.125,t=2.976;P<0.05);观察组患者不良反应发生率显著低于对照组,差异有统计学意义(χ^(2)=4.357,P<0.05)。结论:HHFNC能提高AECOPD合并Ⅱ型呼吸衰竭患者的临床疗效,利于改善临床症状及氧合情况,降低血清HIF-1α及IL-17水平,且不良反应发生率低。

Objective:To study and analyze the curative effect of humidified high flow nasal cannula(HHFNC)in treating acute exacerbation chronic obstructive pulmonary disease(AECOPD)with typeⅡrespiratory failure and the effect of that on serum HIF-1αand IL-17 levels.Methods:120 patients with AECOPD complicated with typeⅡrespiratory failure who were treated in hospital were selected.And they were divided into control group and observation group according to random number table method,with 60 cases in each group.Both two groups of patients underwent conventional basic treatment,and control group received the treatment with nasally continuous positive pressure ventilation on this basis,and observation group received HHFNC treatment on this basis.The treatment effect,heart rate(HR),respiratory rate(RR),arterial partial pressure of oxygen(PaO_(2)),partial pressure of carbon adverse reactions between before and after treatment were analyzed.Results:The total effective rate of observation group was significantly higher than that of control group,the difference was statistically significant(χ^(2)=7.566,P<0.05).Before treatment,there were no significant difference in the levels of HR,RR,PaO_(2),PaCO_(2),SaO_(2),HIF-1αand IL-17 between the two groups(P>0.05).After 3 days of treatment,the levels of HR,RR,PaCO_(2),HIF-1αand IL-17 of two groups decreased,and these indicators of observation group were significantly lower than those of control group(t=5.626,t=8.660,t=5.101,t=7.599,t=8.851,P<0.05),and the levels of PaO_(2) and SaO_(2) of two groups increased,the levels of them of observation group were significantly higher than those of control group(t=10.125,t=2.976,P<0.05).In addition,the incidence of adverse reactions of observation group was significantly lower than that of control group(χ^(2)=4.357,P<0.05).Conclusion:HHFNC can improve the clinical efficacy of AECOPD patients with typeⅡrespiratory failure,and it contribute to improve the clinical symptoms and oxygenation,and reduce the levels of HIF-1αand IL-17.And the incidence of adverse reactions of that is low.