不同吸入氧浓度对AECOPD合并Ⅱ型呼吸衰竭无创机械通气患者血气指标及血清HMGB1、IL-27水平的影响

Effects of Different Concentrations of Inhaled Oxygen on Blood Gas Indexes and Serum HMGB1 and IL-27 Levels in Patients Undergoing Noninvasive Mechanical Ventilation for AECOPD with Type Ⅱ Respiratory Failure

目的 探讨在慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭无创机械通气中应用不同吸入氧浓度对患者血气指标、血清高迁移率族蛋白B1(HMGB1)、白介素-27(IL-27)水平的影响。方法 将80例AECOPD合并Ⅱ型呼吸衰竭患者根据无创机械通气中吸入氧浓度分为A组(吸入氧浓度为45%,n=43)和B组(吸入氧浓度为60%,n=37)。比较2组治疗前后血气指标[包括动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))和pH值]、血清HMGB1、IL-27水平的变化。结果 2组治疗前、治疗后1 d PaO_(2)、PaCO_(2)、pH值比较差异无统计学意义(P>0.05);治疗后7 d,A组PaO_(2)、pH值显著高于B组,PaCO_(2)值显著低于B组(P<0.05)。2组治疗前血清HMGB1、IL-27水平比较差异无统计学意义(P>0.05);治疗后1、7 d,A组血清HMGB1、IL-27水平显著低于B组(P<0.05)。结论 吸入氧浓度为45%时,接受无创机械通气治疗的AECOPD合并Ⅱ型呼吸衰竭患者的血气指标改善效果更好,血清HMGB1、IL-27水平明显下降,效果显著。

Objective To explore the effects of different concentrations of inhaled oxygen on blood gas indexes and serum high mobility group box 1(HMGB1) and interleukin-27(IL-27) levels in patients undergoing noninvasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated by type Ⅱ respiratory failure.Methods According to the concentrations of inhaled oxygen during non-invasive mechanical ventilation,80 patients with AECOPD and type Ⅱ respiratory failure were divided into group A(oxygen concentration 45%,n=43) and group B(oxygen concentration 60%,n=37).Blood gas indexes(arterial oxygen partial pressure of(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)) and pH) and serum HMGB1 and IL-27 levels were compared between the two groups.Results There were no significant differences in PaO_(2),PaCO_(2) and pH between the two groups before and after treatment for 1 day(P>0.05).After treatment for 7 days,compared with the group B,PaO_(2) and pH increased and PaCO_(2) decreased in the group A(P<0.05).Before treatment,serum HMGB1 and IL-27 levels were not significantly different between the two groups(P>0.05).After treatment for 1 and 7 days,the levels of HMGB1 and IL-27 in the group A were lower than those in the group B(P<0.05).Conclusion Noninvasive mechanical ventilation with inhaled oxygen concentration at 45% can significantly improve blood gas indexes and reduce serum HMGB1 and IL-27 levels in AECOPD patients with type Ⅱ respiratory failure.