布地格福联合无创正压通气治疗AECOPD合并呼吸衰竭效果及安全性

Efficacy and safety of budesonide combined with non-invasive positive pressure ventilation in treatment of AECOPD with respiratory failure

目的探讨布地格福吸入气雾剂联合无创正压通气治疗慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者临床效果及安全性。方法以102例AECOPD合并呼吸衰竭患者为研究对象,随机分为观察组与对照组。观察组患者在基础治疗基础上给予无创正压通气联合布地格福吸入气雾剂治疗,对照组患者仅给予无创正压通气治疗。治疗前及治疗2周后,测定患者血清白细胞介素-6(IL-6)和C反应蛋白(CRP)水平,以及第1 s用力呼气容积(FEV1)、用力肺活量(FVC)及1 s率(FEV1/FVC),记录患者治疗期间不良反应发生情况。结果治疗前,观察组和对照组患者FEV1、FVC、FEV1/FVC、血清CRP与IL-6水平差异均无统计学意义(P均>0.05)。治疗2周后,观察组和对照组患者FEV1、FVC、FEV1/FVC、血清CRP与IL-6水平较治疗前均有所提高(P均<0.05);治疗2周后,观察组患者FEV1/FVC为(0.66±0.02)%,高于对照组的(0.60±0.10)%(t=9.90,P=0.030)。治疗2周后,观察组患者血清CRP和IL-6水平分别为(39.29±12.50)mg/L、(17.00±6.36)pg/mL,均低于对照组的(60.97±13.52)mg/L、(36.03±9.74)pg/mL,(t=-5.35、-10.31,P均<0.05)。结论无创正压通气联合布地格福吸入气雾剂治疗可显著改善AECOPD合并呼吸衰竭患者肺功能和血清炎性因子水平,且安全性较高,值得临床推广应用。

ObjectiveTo investigate the clinical efficacy and safety of budesonide inhaled aerosol combined with non-invasive positive pressure ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and respiratory failure.Methods A total of 102 patients with AECOPD and respiratory failure were randomly divided into an observation group and a control group.The patients in the observation group were treated with noninvasive positive pressure ventilation plus budesonide inhaled aerosol in addition to basic treatment,while the patients in the control group were treated with noninvasive positive pressure ventilation alone.Before treatment and 2 weeks after treatment,serum interleukin-6(IL-6)and C-reactive protein(CRP)levels,forced expiratory volume(FEV1),forced vital capacity(FVC),and 1-second rate(FEV1/FVC)were measured,and the occurrence of adverse reactions was recorded during treatment.Results Before treatment,there were no significant differences between FEV1,FVC,FEV1/FVC,serum CRP and IL-6 levels between the observation group and the control group(all P>0.05).After 2 weeks of treatment,the levels of FEV1,FVC,FEV1/FVC,serum CRP and IL-6 in the observation group and control group were improved compared with those before treatment(P<0.05).After 2 weeks of treatment,the FEV1/FVC in the observation group was(0.66±0.02)%,which was higher than that of(0.60±0.10)%in the control group(t=9.90,P=0.030).After 2 weeks of treatment,the serum CRP and IL-6 levels in the observation group were(39.29±12.50)mg/L and(17.00±6.36)pg/mL,respectively,which were lower than(60.97±13.52)mg/L,(36.03±9.74)pg/mL in the control group(t=-5.35,-10.31,both P<0.05).Conclusion Noninvasive positive pressure ventilation combined with budesonide inhaled aerosol therapy can significantly improve lung function and serum inflammatory factor levels in patients with AECOPD and respiratory failure,and the safety profile is high,which is worthy of clinical application.