高流量氧疗湿化治疗仪联合还原型谷胱甘肽治疗慢性阻塞性肺疾病急性加重期患者的疗效

Curative effect of high flow humidified oxygen delivery device combined with glutathione on AECOPD patients

目的 探讨高流量氧疗湿化治疗仪联合还原型谷胱甘肽(GSH)治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及对血清炎症因子水平的影响。方法 将2021年4月至2022年5月医院收治的AECOPD患者128例患者作为研究对象,根据1∶1随机法将患者分为观察组与对照组,每组各64例,对照组予以高流量氧疗湿化治疗仪治疗,观察组在对照组基础上联合GSH,均持续治疗2周。评估两组临床疗效。于治疗前后,比较患者血清炎症因子[血清胱抑素-C(CysC)、C反应蛋白(CRP)、降钙素原(PCT)、基质金属蛋白酶(MMP)-9]、氧化应激反应指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)、过氧化氢酶(CAT)]、肺功能指标[呼气峰流速(PEF)、第一秒用力呼气量(FEV1)和FEV1/用力肺活量(FVC)]和血气指标[酸碱度(pH值)、二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO2)]水平变化,并记录不良事件发生率。结果 观察组临床总有效率明显高于对照组(96.88%vs.87.50%)(P <0.05)。治疗后,两组PCT、CysC、CRP和MMP-9水平均降低,且观察组低于对照组(P <0.05);治疗后观察组SOD、GSH-PX、CAT、PEF、FEV1、FEV1/FVC水平均高于对照组,MDA水平低于对照组(P <0.05);治疗后,观察组pH值、PaO2水平高于对照组,PaCO_(2)水平低于对照组(P <0.05)。观察组与对照组不良事件发生率对比差异无统计学意义(3.12%vs. 4.69%)(P> 0.05)。结论 高流量氧疗湿化治疗仪联合GSH治疗AECOPD患者的疗效较好,可有助于缓解炎症反应和应激反应,改善肺功能与动脉血气。

Objective To explore the curative effect of high flow humidified oxygen delivery device combined with glutathione(GSH)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its influences on levels of serum inflammatory factors.Methods A total of 128 patients with AECOPD admitted to the hospital from April 2021 to May 2022 were enrolled as the research objects.They were randomly divided into control group treated with high flow humidified oxygen delivery device and observation group treated with high flow humidified oxygen delivery device and GSH,with 64 cases in each group.Bothgroups were continuously treated for 2 weeks.The clinical curative effect in both groups was evaluated.Before and after treat⁃ment,changes in levels of serum inflammatory factors[serum cystatin C(CysC),C⁃reactive protein(CRP),pro⁃calcitonin(PCT),matrix metalloproteinase(MMP)⁃9],oxidative stress indexes[superoxide dismutase(SOD),glutathione peroxidase(GSH⁃PX),malondialdehyde(MDA),catalase(CAT)],pulmonary function indexes[peak expiratory flow(PEF),forced expiratory volume in 1s(FEV1),FEV1/forced vital capacity(FVC)]and blood gas indexes[pH,partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2)]were compared.The incidence of adverse events was recorded.Results The total clinical response rate in the observation group was significantly higher than that in the control group(96.88%vs.87.50%,P<0.05).Levels of PCT,CysC,CRP and MMP⁃9 in both groups were decreased,which were especially lower in the observation group(P<0.05).Levels of SOD,GSH⁃PX,CAT,PEF,FEV1 and FEV1/FVC in the observation group were higher than those in the control group,while MDA was lower than that in the control group(P<0.05).pH and PaO2 in the observation group were higher than those in the control group,while PaCO2 was lower than that in control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(3.12%vs.4.69%,P>0.05).Conclusion Curative effect of high flow humidified oxygen delivery device combined with GSH is good for AECOPD patients,which is conducive to relieving inflammation and stress response,improving pulmonary function and arterial blood gas.