ICS/LABA联合无创呼吸机对慢性阻塞性肺疾病患者的治疗效果及对免疫功能的影响

The therapeutic effect of ICS/Laba combined with noninvasive ventilator on COPD patients and its influence on immune function

目的:探究ICS/LABA联合无创呼吸机对慢性阻塞性肺疾病(慢阻肺)患者的治疗效果及对免疫功能的影响。方法:选取2018年10月~2019年10月慢阻肺患者124例,采用随机数字表法将患者分为单一无创组与联合治疗组,各62例。其中单一无创组使用无创呼吸机进行治疗,联合治疗组使用ICS/LABA联合无创呼吸机。使用全自动血气分析仪对两组患者pH值、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))进行检测,使用瑞典NIOX呼出一氧化碳测定系统测定FeNO值,采用肺功能检测仪检测肺活量(FVC)、第1秒用力呼气量容积(FEV_(1))、第1秒用力呼气容积占用力肺活量百分比(FEV_(1)/FVC)指标,使用酶联免疫吸附法检测白介素-6(IL-6)、肿瘤细胞因子-α(TNF-α)水平,采用流式细胞仪检测Th1、Th2、Th1/Th2指标。采用SPSS 21.0进行统计学处理,以P<0.05为差异有统计学意义。结果:治疗后,联合治疗组pH、PaO_(2)水平高于单一无创组,PaCO_(2)水平低于单一无创组,差异有统计学意义(P<0.05);治疗后,联合治疗组FVC、FEV_(1)、FEV_(1)/FVC水平高于单一无创组,FeNO水平低于单一无创组,差异有统计学意义(P<0.05);治疗后,两组患者IL-6、TNF-α水平均降低,联合治疗组IL-6、TNF-α水平均显著低于单一无创组,差异有统计学意义(P<0.05);治疗后,两组患者Th1、Th2、Th1/Th2水平均升高,联合治疗组Th1、Th2、Th1/Th2水平均高于单一无创组,差异有统计学意义(P<0.05);联合治疗组不良反应总发生率略高于单一无创组,但两组比较,差异无统计学意义(P>0.05)。结论:使用ICS/LABA联合无创呼吸机对慢阻肺患者进行治疗,能够改善血气指标,降低炎性反应程度,显著提高肺功能情况以及免疫功能。

Objective To explore the therapeutic effect of ICS/Laba combined with noninvasive ventilator on COPD patients and its influence on immune function.Method From October 2018 to October 2019,124 patients with chronic obstructive pulmonary disease(COPD)were selected.The patients were divided into single noninvasive group and combined treatment group,62 cases in each group.The single noninvasive group used non-invasive ventilator to treat COPD patients,and the combined treatment group used ICS/Laba combined with non-invasive ventilator to treat COPD patients.The pH value,PaO_(2) and PaCO_(2) of the two groups were measured by the automatic blood gas analyzer.The FeNO value was measured by the NiOx exhaled carbon monoxide system in Sweden.The FVC,FEV_(1) and FEV of the first second were measured by the pulmonary function tester The levels of IL-6 and TNF-αwere measured by enzyme-linked immunosorbent assay,and Th1,Th2 and Th1/Th2 were measured by flow cytometry.SPSS 21.0 was used for statistical treatment,P<0.05 was statistically significant.Results After treatment,compared with the single non-invasive group,the pH and PaO_(2) levels of the combined treatment group were higher than that of the single non-invasive group,and the PAC2 level was lower than that of the single non-invasive group(P<0.05);after treatment,compared with the single non-invasive group,the FVC,FEV_(1) and FEV_(1)/FVC levels of the combined treatment group were higher than that of the single non-invasive group,and the FeNO level was lower than that of the single non-invasive group(P<0.05);after treatment,the IL-6 and TNF-αlevels of the two groups were reduced.Compared with the single non-invasive group,the levels of IL-6 and TNF-αin the combined treatment group were significantly lower than those in the single non-invasive group(P<0.05);after treatment,the levels of Th1,Th2 and Th1/Th2 in the two groups were increased,and the levels of Th1,Th2 and Th1/Th2 in the combined treatment group were higher than those in the single non-invasive group(P<0.05);the total incidence of adverse reactions in the combined treatment group was slightly higher than that in the single non-invasive group,but there was no significant difference between the two groups(P>0.05).Conclusion The use of ICS/Laba combined with non-invasive ventilator in the treatment of COPD patients can improve blood gas index,reduce the degree of inflammatory response,significantly improve lung function and immune function.