COPD并RF经NIPPV后Fib、D-D、血气参数的变化及与肺功能的关系

Relationship between the changes of Fib,D-D and blood gas parameters of COPD combined with RF after NIPPV and lung function

目的探究慢性阻塞性肺疾病(COPD)并呼吸衰竭(RF)经无创正压通气(NIPPV)治疗后纤维蛋白原(Fib)、D-二聚体(D-D)、血气参数的变化及与肺功能的关系。方法将2018年4月至2021年2月于首都医科大学附属北京世纪坛医院治疗的98例COPD合并RF患者作为研究组,选取同期86例健康体检者作为对照组。比较研究组治疗前后与对照组Fib、D-D、血气参数[动脉血氧分压(PaO;)、动脉血二氧化碳分压(PaCO;)]、肺功能[用力肺活量(FVC)、一秒用力呼气容积(FEV1)、FEV1/FVC];分析COPD合并RF的Fib、D-D、血气参数与肺功能的相关性。结果Fib、D-D、PaCO;水平:研究组治疗前>研究组治疗后>对照组,PaO;、FVC、FEV1、FEV1/FVC水平:研究组治疗前<研究组治疗后<对照组,差异有统计学意义(P<0.05)。COPD并RF患者Fib、D-D、PaCO;与FVC、FEV1、FEV1/FVC呈负相关(P<0.05),PaO;与FVC、FEV1、FEV1/FVC呈正相关(P<0.05)。结论COPD合并RF患者肺功能受损会影响Fib、D-D、血气参数,采取NIPPV治疗后能有效改善患者的肺功能、血气参数,有助于患者呼吸系统的恢复,减轻血液高凝状态。

Objective To explore the relationship between the changes of fibrinogen(Fib),D-dimer(DD)and blood gas parameters in patients of chronic obstructive pulmonary disease(COPD)combined with respiratory failure(RF)after noninvasive intermittent positive pressure ventilation(NIPPV)and lung function.Methods The clinical data of 98 COPD patients with RE who were treated in Beijing Shijitan Hospital,Capital Medical University from April 2018 to February 2021 were selected as the study group;another 86 cases who had health examination were selected as the control group.Compared The levels of Fib,DD,and blood gas parameters[arterial partial pressure of oxygen(PaO;),arterial Partial pressure of carbon dioxide inartery(PaCO;)],lung function[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and FEV1/FVC were compared between the study group and the control group before and after treatment.The correlation between Fib,DD,blood gas parameters of COPD combined with RF and lung function was analyzed.Results Fib,DD,Pa CO;levels:before treatment in the study group>after treatment in the study group>the control group.Pa O;,FVC,FEV1,FEV1/FVC levels:before treatment in the study group<after treatment in the study group<the control group,the difference was statistically significant(P<0.05).Fib,DD,Pa CO;were negatively correlated with FVC,FEV1,FEV1/FVC,and Pa O;was positively correlated with FVC,FEV1,FEV1/FVC in COPD patients with RF(P<0.05).Conclusion Impaired lung function in patients with COPD and RF can affect the levels of Fib,D-D,and blood gas parameters.NIPPV treatment can effectively improve the patient’s lung function and blood gas parameters,help the recovery of the patient’s respiratory system,and reduce blood hypercoagulability.