乙酰半胱氨酸雾化吸入配合无创呼吸机NIPSV模式通过调节免疫炎症反应治疗AECOPD合并呼吸衰竭的机制OACSTPCD
The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response
目的 探究乙酰半胱氨酸雾化吸入配合无创呼吸机压力支持通气(NIPSV)模式通过调节免疫炎症反应治疗慢性阻塞性肺疾病急性期(AECOPD)合并呼吸衰竭的机制.方法 选取 2020 年 2 月至 2022 年 12 月于安徽省桐城市人民医院就诊的AECOPD合并呼吸衰竭患者共计 80 例,依据治疗方案不同分为实验组(n=42)及对照组(n=38),实验组采用无创呼吸机NIPSV模式联合乙酰半胱氨酸雾化吸入,对照组采用无创呼吸机NIPSV模式,对比 2 组治疗前后肺功能:包括第 1 秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC;血气指标:动脉血氧分压(PaO2)、动脉血二氧化碳(PaCO2)、血氧饱和度(SaO2);血清指标:白介素-6(IL-6)、淀粉样蛋白A(SAA)、C 反应蛋白(CRP)、T淋巴细胞亚群(CD3+、CD4+、CD8+)水平,比较治疗期间不良反应发生率.结果 治疗后实验组FEV1、FVC、FEV1/FVC水平均明显高于对照组及治疗前(P<0.05);治疗后实验组PaO2、PaCO2、SaO2 水平高于对照组及治疗前(P<0.05);治疗后实验组IL-6、SAA、CRP水平低于对照组及治疗前(P<0.05);治疗后 2 组CD3+、CD4+水平均升高,实验组高于对照组,CD8+水平降低,实验组低于对照组(P<0.05);实验组不良反应发生率明显低于对照组(P<0.05).结论 AECOPD合并呼吸衰竭患者无创呼吸机NIPSV模式联合乙酰半胱氨酸吸入通过调节免疫炎症反应治疗后,能有效减轻炎性反应,提高肺功能及免疫功能的同时改善患者的血气指标.
Objective To explore the mechanism of acetylcysteine aerosol inhalation combined with non-invasive ventilator pressure supported ventilation(NIPSV)in the treatment of acute stage of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure by regulating the immune inflammatory response.Methods A total of 80 patients with AECOPD combined with respiratory failure who were treated in Tongcheng People's Hospital of Anhui Province from February 2020 to December 2022 were selected and divided into experimental group(n=42)and control group(n=38)according to different treatment plans.The experimental group was treated with NIPSV mode combined with acetyl cysteine atomization inhalation.The control group was treated with non-invasive ventilator NIPSV mode.The pulmonary function of the two groups before and after treatment was compared,including forced expiratory volume(FEV1),forced vital capacity(FVC)and FEV1/FVC.Blood gas index:arterial partial pressure of oxygen(PaO2),arterial carbon dioxide(PaCO2),and blood oxygen saturation(SaO2);Serum indicators:Interleukin-6(IL-6),amyloid A(SAA),C-reactive protein(CRP),T lymphocyte subsets(CD3+,CD4+,CD8+)levels,and the incidence of adverse reactions during treatment were compared.Results After treatment,the levels of FEV1,FVC and FEV1/FVC in experimental group were significantly higher than those in control group and before treatment(P<0.05).After treatment,PaO2,PaCO2 and SaO2 levels in the experimental group were higher than those in the control group and before treatment(P<0.05).The levels of IL-6,SAA and CRP in the experimental group after treatment were lower than those in the control group and before treatment(P<0.05).After treatment,the levels of CD3+and CD4+were increased in both groups,the experimental group was higher than the control group,the CD8+level was lower in the experimental group than the control group(P<0.05).The incidence of adverse reactions in experimental group was significantly lower than that in control group(P<0.05).Conclusion AECOPD combined with non-invasive ventilator NIPSV and acetylcysteine inhalation can effectively reduce the inflammatory response,improve lung function and immune function,and improve blood gas indexes in patients with respiratory failure.
张维华;秦珊珊;温思聪;吴平宇;宋昭光
安徽省桐城市人民医院重症医学科,安徽 桐城 231400
临床医学
慢性阻塞性肺疾病急性期呼吸衰竭无创呼吸机压力支持通气乙酰半胱氨酸
Acute phase of chronic obstructive pulmonary diseaseRespiratory failureNon invasive ventilator pressure support ventilationAcetylcysteine
《昆明医科大学学报》 2024 (007)
113-118 / 6
安徽省卫生厅医药科研计划基金资助项目(12925KJ2017B17)
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