经鼻高流量湿化氧疗联合莫西沙星溶液雾化吸入在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭中的疗效观察

HFNC combined moxifloxacin solution nebulization in the treatment of patients with COPD and type II respiratory failure

目的探讨经鼻高流量湿化氧疗(HFNC)联合莫西沙星溶液雾化吸入在慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭中的疗效。方法纳入86例慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者,分为对照组(n=43)、观察组(n=43)。对照组予以经鼻高流量湿化氧疗治疗,观察组予以经鼻高流量湿化氧疗联合莫西沙星溶液雾化吸入治疗,比较2组患者治疗前后的6 min步行距离(6 MWD),改良医学研究学会呼吸困难量表(MMRC)、慢性阻塞性肺疾病评估量表(CAT)评分,动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血浆内皮素-1(EF-1)、组织金属蛋白酶抑制剂-1(TIMP-1)、基质金属蛋白酶-9(MMP-9)、第1 s用力呼气容积(FEV_(1))、第1 s用力呼气容积与用力肺活量的比值(FEV_(1)/FVC)、丙二醛(MDA)、超氧化物歧化酶(SOD)的水平。结果观察组治疗后6 MWD较对照组长(P<0.05),MMRC评分、CAT评分较对照组低(P<0.05);观察组PaO_(2)、FEV_(1)、FEV_(1)/FVC、SOD水平较对照组高(P<0.05);观察组PaCO_(2)、EF-1、TIMP-1、MMP-9、MDA水平较对照组低(P<0.05)。结论经鼻高流量湿化氧疗联合莫西沙星溶液雾化吸入在慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的应用可以显著提高患者的运动能力、呼吸功能、生活质量、血气指标和肺功能,同时减少炎症反应和氧化应激。

Objective To explore the efficacy of high-flow nasal cannula(HFNC)oxygen therapy combined with moxifloxacin solution nebulization in patients with chronic obstructive pulmonary disease(COPD)and type Ⅱ respiratory failure.Methods The study included 86 patients with COPD and type Ⅱ respiratory failure treated.Patients were divided into groups using a random method,with odd numbers assigned to the control group(n=43)receiving HFNC oxygen therapy alone,and even numbers assigned to the treatment group(n=43)receiving HFNC oxygen therapy combined with moxifloxacin solution nebulization.The two groups were compared before and after treatment in terms of 6-minute walk distance(6 MWD),respiratory function accessed by Modified Medical Research Council Dyspnea Scale(MMRC),quality of life accessed by Chronic Obstructive Pulmonary Disease Assessment Test(CAT),blood gas indicators included arterial oxygen tension(PaO_(2))and arterial carbon dioxide tension(PaCO_(2)),serum inflammatory markers included plasma endothelin-1(EF-1),tissue inhibitor of metalloproteinases-1(TIMP-1),matrix metalloproteinase-9(MMP-9),lung function accessed with forced expiratory volume in the first second(FEV1),ratio of FEV1 to forced vital capacity(FEV1/FVC),and oxidative stress markers included malondialdehyde(MDA),superoxide dismutase(SOD).Results After treatment,the treatment group showed significant improvements in 6MWD,MMRC score,CAT score,PaO_(2),FEV1,FEV1/FVC,and reductions in PaCO_(2),EF-1,TIMP-1,MMP-9,and MDA levels,with increased SOD levels compared to the control group(P<0.05).Conclusion The application of HFNC combined with moxifloxacin solution nebulization in patients with COPD and type Ⅱ respiratory failure can significantly improve patients′exercise capacity,respiratory function,quality of life,blood gas indicators,and lung function,while reducing inflammatory responses and oxidative stress.