摘要
目的:探讨用胸腺肽联合无创正压通气(NPPV)治疗急性加重期慢性阻塞性肺疾病(COPD)合并呼吸衰竭的效果及对患者炎症反应的影响。方法:选取江陵县人民医院收治的92例急性加重期COPD合并呼吸衰竭患者作为观察对象。按照随机数表法将其分为常模组和探讨组。对两组患者均进行常规治疗,在此基础上用胸腺肽对常模组46例患者进行治疗,用胸腺肽联合NPPV对探讨组46例患者进行治疗。比较两组患者治疗前后的血清炎性因子水平及肺功能指标。结果:治疗前,两组患者血清白细胞介素-6、肿瘤坏死因子-α、C反应蛋白的水平、用力肺活量(FVC)、1 s用力呼气容积(FEV_(1))及FEV_(1)/FVC相比(P>0.05)。治疗后,探讨组患者血清白细胞介素-6、肿瘤坏死因子-α、C反应蛋白的水平均低于常模组患者,其FVC、FEV_(1)、FEV_(1)/FVC均高于常模组患者(P<0.05)。结论:在对急性加重期COPD合并呼吸衰竭患者进行常规治疗的基础上,用胸腺肽联合NPPV对其进行治疗能显著改善其肺功能,减轻其机体的炎症反应。
Objective:To investigate the effect of thymosin combined with non-invasive positive pressure ventilation(NPPV)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated with respiratory failure and its effect on inflammatory response.Methods:A total of 92 patients with acute exacerbation COPD and respiratory failure admitted to jiangling County People’s Hospital were selected as observation objects.According to the random number table method,they are divided into the norm group and the discussion group.On the basis of conventional treatment,46 patients in the normal group were treated with thymic peptide,and 46 patients in the discussion group were treated with thymic peptide combined with NPPV.The levels of serum inflammatory factors and lung function indexes were compared between the two groups before and after treatment.Results:Before treatment,the s erum levels of interleukin-6,tumor necros is factor-α,C-reactive protein,forced vital capacity(FVC),1 s forced expiratory volume(FEV_(1))and FEV_(1)/FVC in 2 groups were compared(P>0.05).After treatment,the levels of serum interleukin-6,tumor necrosis factor-αand C-reactive protein in the study group were lower than those in the normal group,and the levels of FVC,FEV_(1) and FEV_(1)/FVC were higher than those in the normal group(P<0.05).Conclusion:On the basis of conventional treatment for patients with acute exacerbation COPD combined with respiratory failure,treatment with thymosin combined with NPPV can significantly improve thei r lung function and reduce their inflammatory response.
作者
鄢具敏
YAN Jumin(Department of Intensive Care Medicine,Jiangling County People’s Hospita l,Jiangling Hubei 434100)
关键词
胸腺肽
无创正压通气
急性加重期慢性阻塞性肺疾病
呼吸衰竭
炎症反应
thymosin
Noninvasive positive pressure ventilation
Acute exacerbation of chronic obstructive pulmonary disease
Respiratory failure
The inflammatory response