双水平持续气道正压联合苯磺酸氨氯地平片治疗老年肺结核肺功能受损合并高血压的临床研究

Clinical study of bi-level positive airway pressure combined with Amlodipine Besylate Tablets in the treatment of elderly patients with pulmonary tuberculosis and impaired pulmonary function complicated with hypertension

目的研究双水平持续气道正压(BiPAP)联合苯磺酸氨氯地平片治疗老年肺结核肺功能受损合并高血压的临床效果。方法选取2021年4月至2022年4月景德镇市第五人民医院内科和景德镇市中心血站的60例老年肺结核肺功能受损合并高血压患者作为研究对象,采用随机数字表法分为治疗组和对照组,每组30例。两组患者均给予抗结核、止咳、止血等常规治疗,对照组在常规治疗的基础上给予苯磺酸氨氯地平片降压治疗,观察组在上述基础上给予BiPAP。比较两组患者治疗前后的心率、呼吸频率、血气指标[动脉血二氧化碳分压(PaCO_(2)),动脉血氧分压(PaO_(2)),酸碱度(pH)的变化]及收缩压(SBP)和舒张压(DBP)水平。结果治疗后两组患者的心率、呼吸频率、PaCO_(2)均低于本组治疗前,PaO_(2)和pH值均高于本组治疗前,差异有统计学意义(P<0.05);且观察组治疗后的心率、呼吸频率、PaCO_(2)水平低于对照组,PaO_(2)水平和pH值高于对照组,差异有统计学意义(P<0.05)。两组患者治疗后的日间及夜间SBP、DBP水平均低于本组治疗前,且观察组治疗后的日间及夜间SBP、DBP水平低于对照组,差异有统计学意义(P<0.05)。结论BiPAP联合苯磺酸氨氯地平片可增强老年肺结核患者的肺通气功能,有效控制血压水平。

Objective To study the clinical effect of bi-level positive airway pressure(BiPAP)combined with Amlodipine Besylate Tablets in the treatment of elderly patients with pulmonary tuberculosis and impaired pulmonary function complicated with hypertension.Methods From April 2021 to April 2022,60 elderly patients with impaired pulmonary function and hypertension in the Department of Internal Medicine of Jingdezhen Fifth People's Hospital and Jingdezhen Central Blood Station were selected as research objects,they were divided into the treatment group and the control group according to random number table method,with 30 cases in each group.Both groups were given routine treatment such as antituberculosis,relieving cough and hemostasis.The control group was given Amlodipine Besylate Tablets to reduce blood pressure on the basis of routine treatment,and the observation group was given BiPAP on the basis of the above.The heart rate,respiratory rate,blood gas indexes(changes of arterial partial pressure of carbon dioxide[PaCO_(2)],arterial partial pressure of oxygen[PaO_(2)],power of hydrogen[pH]),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were compared between the two groups before and after treatment.Results After treatment,the heart rate,respiratory rate and PaCO_(2)of patients in the two groups were lower than those before treatment,and the levels of PaO_(2)and pH in the two groups were higher than those before treatment,the differences were statistically significant(P<0.05).The heart rate,respiratory rate and PaCO_(2)level of the observation group after treatment were lower than those of the control group,while PaO_(2)level and pH value of the observation group after treatment were higher than those of the control group,the differences were statistically significant(P<0.05).The daily and nighttime SBP and DBP levels of the two groups after treatment were lower than those before treatment,and the daily and nighttime SBP and DBP levels of the observation group after treatment were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion BiPAP combined with Amlodipine Besylate Tablets can enhance the pulmonary ventilation function in elderly patients with pulmonary tuberculosis,and effectively control blood pressure.