布地奈德联合NAC氧化驱动雾化对AECOPD患者治疗疗效及血气指标的影响

Effect of budesonide combined with NAC oxidation-driven nebulization on the therapeutic efficacy and blood gas indicators of AECOPD patients

目的:探究布地奈德联合N-乙酰半胱氨酸(N-acetylcysteine,NAC)氧化驱动雾化对慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的治疗疗效及血气指标的影响。方法:选取2020年1月至2023年12月我院66例AECOPD患者,随机分为实验组和对照组,每组33例。对照组实施常规治疗以及NAC氧化驱动雾化治疗(每次3 mL,每天2次,氧流量4 mL·min-1,每次20 min),实验组在对照组基础上加用布地奈德吸入(1 mg,每天2次)治疗,两组均持续治疗2 w。比较两组疗效,分别在治疗前后用血气分析仪检测动脉血氧分压(Oxygen partial pressure,PaO_(2))、二氧化碳分压(Carbon dioxide partial pressure,PaCO_(2))、血氧饱和度(Oxygen saturation,SaO_(2)),采用酶联免疫吸附法测定血清白细胞介素-6(Interleukin 6,IL-6)水平,用免疫比浊法检测降钙素原(Procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)水平,统计并比较两组并发症发生情况。结果:实验组患者治疗总有效率为96.97%,高于对照组的81.82%(P<0.05);实验组患者治疗后的PaO_(2)和SaO_(2)均高于对照组,PaCO_(2)低于对照组(P<0.05);实验组患者治疗后的IL-6、PCT、CRP均低于对照组(P<0.05);两组不良反应比较差异无统计学意义(P>0.05)。结论:布地奈德联合NAC氧化驱动雾化有利于提高AECOPD患者临床疗效,并且能有效改善血气指标水平。

Objective:To explore the therapeutic effect of budesonide combined with N-acetylcysteine(NAC)oxidation-driven nebulization on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its impact on blood gas parameters.Methods:Sixty-six patients with AECOPD in our hospital from January 2020 to December 2023 were randomly divided into two groups(n=33).The control group received NAC oxidation-driven atomization treatment(3 mL each time,twice one day,oxygen flow 4 mL•min-1,20 min each time).The experimental group received budesonide inhalation(1 mg,twice one day)based on the control group.Both groups were treated for 2 weeks.The curative effects of the two groups were compared.The arterial partial pressure(PaO_(2)),carbon dioxide partial pressure(PaCO_(2)),and oxygen saturation(SaO_(2))were detected by a blood gas analyzer before and after treatment.The serum interleukin-6(IL-6)level was measured by enzyme-linked immunosorbent assay.The levels of procalcitonin(PCT)and C reactive protein(CRP)were detected by immunoturbidimetry.The incidence of complications in the two groups was statistically analyzed and compared.Results:The total effective rate of the experimental group was 96.97%,which was higher than that of the control group(81.82%)(P<0.05).The PaO_(2) and SaO_(2) of the patients in the experimental group were higher than those in the control group after treatment,while the PaCO_(2) was lower than that in the control group(P<0.05).The levels of IL-6,PCT,and CRP in the experimental group after treatment were significantly lower than those in the control group(p<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Budesonide combined with NAC oxidation-driven atomization can improve the clinical efficacy of AECOPD patients,and can effectively improve the blood gas index level.