两种通气模式治疗COPD合并Ⅱ型呼吸衰竭对CRP、IL-8及IL-27的影响

Effect of two ventilation modes on CRP,IL-8 and IL-27 in the treatment of COPD complicated with type Ⅱ respiratory failure

目的 探讨无创呼吸机SXX模式、ST模式治疗对慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭患者血清C反应蛋白(CRP)、白细胞介素-8(IL-8)、白细胞介素-27(IL-27)水平和呼吸力学指标的影响。方法 选取2018年5月至2020年10月西安交通大学第二附属医院收治的116例COPD合并Ⅱ型呼吸衰竭患者,根据不同治疗方法分为观察组52例(SXX模式)和对照组64例(ST模式)。比较两组临床疗效、炎症指标(CRP、IL-8、IL-27)、呼吸力学指标[潮气量(VT)、呼吸频率(f)、每分通气量(MV)、吸气/呼吸周期时间比(Ti/T)]水平,观察两组治疗安全性。结果 观察组治疗后总有效率96.15%明显高于对照组84.38%,差异有统计学意义(P<0.05)。治疗后两组CRP、IL-8、IL-27水平均下降,观察组上述指标水平低于对照组,差异有统计学意义(P<0.05)。与治疗前比较,两组患者VT增加,f下降(P<0.05);观察组VT高于对照组,f低于对照组,差异有统计学意义(P<0.05);治疗前后两组MV、Ti/T比较,差异无统计学意义(P>0.05)。两组不良反应发生比较(观察组:5.77%vs对照组:9.38%),差异无统计学意义(P>0.05)。结论 SXX模式在改善炎症指标方面优于ST模式,该模式治疗COPD合并Ⅱ型呼吸衰竭患者有利于实现最佳通气效果。

Objective To investigate the effects of non-invasive ventilator SXX mode and ST mode in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with type Ⅱrespiratory failure on their serum C-reactive protein(CRP),Interleukin-8(IL-8),Interleukin-27(IL-27)levels and respiratory mechanics indicators. Methods 116 patients with COPD and type II respiratory failure admitted to the Second Affiliated Hospital of Xi’an Jiaotong University from May 2018 to October 2020 were selected. According to different treatment methods,they were divided into the observation group 52 cases(SXX mode)and 64 cases in the control group(ST mode). The clinical efficacy,inflammation index(CRP,IL-8,IL-27),and respiratory mechanics index levels[tidal volume(VT),respiratory frequency(f),minute ventilation(MV),inspiratory/respiratory cycle time between the two groups Ratio(Ti/T)]were compared between the two groups,and the safety of the two groups was observed. Results The total effective rate of 96.15% in the observation group was significantly higher than that in the control group 84.38%,and the difference was statistically significant(P<0.05). After treatment,the levels of CRP,IL-8 and IL-27 in the two groups decreased;the levels of the above indicators in the observation group were lower than those in the controlgroup,and the difference was statistically significant(P<0.05). Compared with before treatment,the VT of the two groups of patients increased,and f decreased(P<0.05);the VT of the observation group was higher than that of the control group,and f was lower than that of the control group,and the difference was statistically significant(P<0.05). Compared with Ti/T,the difference was not statistically significant(P>0.05). Comparison of adverse reactions between the two groups(observation group:5.77% vs control group:9.38%),the difference was not statistically significant(P>0.05). Conclusion SXX mode is better than ST mode in improving inflammation indicators,which is beneficial to achieve the best ventilation effect in the treatment of COPD patients with type Ⅱ respiratory failure.