布地奈德雾化吸入治疗老年支气管哮喘合并Ⅱ型呼吸衰竭疗效观察
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摘要
目的探讨双水平呼吸道正压通气(BiPAP)联合布地奈德雾化吸入治疗老年支气管哮喘合并Ⅱ型呼吸衰竭的效果。方法以2014年3月至2015年10月接受治疗的支气管哮喘合并Ⅱ型呼吸衰竭的老年患者为观察对象。并根据其治疗方式分为对照组和观察组,每组40例。对照组给予BiPAP治疗,观察组给予BiPAP联合布地奈德雾化吸入治疗。观察2组患者的治疗效果,比较2组患者治疗前后炎症细胞因子、血气指标和肺功能指标的差异。结果观察组治疗的有效率为95.00%,明显高于对照组(77.50%),差异有统计学意义(P<0.05);治疗前,2组患者的IL-8、IL-17、hs-CRP、TNF-α等实验室指标差异无统计学意义(P>0.05),治疗后,2组患者的上述指标均下降,而观察组下降更为明显(P<0.05);2组患者治疗前的肺功能和血气指标差异无统计学意义(P>0.05),治疗后,2组患者的FVC、FEV1、FEV1/FVC、PaO_2和pH值均较治疗前升高,PaCO_2均较治疗前降低,且观察组变化更明显(P<0.05)。结论 BiPAP联合布地奈德雾化吸入对老年支气管哮喘合并Ⅱ型呼吸衰竭患者有较好的治疗效果,可明显改善患者相关实验室指标,具有临床推广应用价值。
Objective To observe the therapeutic effects of BiPAP combined with budesonide aerosol inhalation on senile bronchial asthma complicated by type Ⅱ respiratory failure. Methods The elderly patients with bronchial asthma complicated by type Ⅱ respiratory failure who were treated in our hospital from March 2014 to October 2015 were enrolled as objectss. According to the treatment way,these patients were divided into control group and observation group,with 40 patients in each group. The patients in control group were treated by BiPAP,however,the patients in observation group were treated by BiPAP combined with budesonide aerosol inhalation. The therapeutic effects after treatment,inflammatory cytokines,blood gas indexes and lung function indicators before and after treatment were observed and compared between two groups. Results The effective rate in observation group was 95%,which was significantly higher than that(77. 50%) in control group(P <0. 05). Before treatment,there were no significant differences in the serum levels of IL-8,IL-17,hs-CRP,TNF-α and other laboratory indicators between two groups(P > 0. 05). However after treatment,these indexes mentioned above were decreased in both groups,moreover,the decrease extent in observation group was more obvious than that in control group(P <0. 05). Before treatment there were no significant differences in patient's lung function and blood gas indexes between two groups(P > 0. 05),after treatment,the levels of FVC,FEV1,FEV1/FVC,FEV1,PaO_2 and PH were increased in both groups,however,the levels of PaO_2 were decreased,moreover,the changes in observation group were more obvious than those in control group(P < 0. 05). Conclusion The BiPAP combined with budesonide inhalation has better therapeutic effects on bronchial asthma complicated by type Ⅱ respiratory failure in the elderly,which can obviously improve related laboratory indexes,therefor,which is worth using widely in clinical practice.
Objective To observe the therapeutic effects of BiPAP combined with budesonide aerosol inhalation on senile bronchial asthma complicated by type Ⅱ respiratory failure. Methods The elderly patients with bronchial asthma complicated by type Ⅱ respiratory failure who were treated in our hospital from March 2014 to October 2015 were enrolled as objectss. According to the treatment way,these patients were divided into control group and observation group,with 40 patients in each group. The patients in control group were treated by BiPAP,however,the patients in observation group were treated by BiPAP combined with budesonide aerosol inhalation. The therapeutic effects after treatment,inflammatory cytokines,blood gas indexes and lung function indicators before and after treatment were observed and compared between two groups. Results The effective rate in observation group was 95%,which was significantly higher than that(77. 50%) in control group(P <0. 05). Before treatment,there were no significant differences in the serum levels of IL-8,IL-17,hs-CRP,TNF-α and other laboratory indicators between two groups(P > 0. 05). However after treatment,these indexes mentioned above were decreased in both groups,moreover,the decrease extent in observation group was more obvious than that in control group(P <0. 05). Before treatment there were no significant differences in patient's lung function and blood gas indexes between two groups(P > 0. 05),after treatment,the levels of FVC,FEV1,FEV1/FVC,FEV1,PaO_2 and PH were increased in both groups,however,the levels of PaO_2 were decreased,moreover,the changes in observation group were more obvious than those in control group(P < 0. 05). Conclusion The BiPAP combined with budesonide inhalation has better therapeutic effects on bronchial asthma complicated by type Ⅱ respiratory failure in the elderly,which can obviously improve related laboratory indexes,therefor,which is worth using widely in clinical practice.
引文
1魏龙,李玉婷,秦勇,等.BiPAP联合雾化吸入治疗慢性阻塞性肺疾病并Ⅱ型呼吸衰竭的疗效.新疆医学,2014,44:67-69.
2 黄满兴.舒利迭联合BiPAP治疗老年COPD合并Ⅱ型呼吸衰竭的临床价值.深圳中西医结合杂志,2015,25:22-23.
3 刘芳英,钱叶长,危蕾,等.双水平正压通气联合雾化吸入在高龄患者慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭治疗中的应用.蚌埠医学院学报,2014,39:195-197.
4 Feng XL,Wang LP,Zhu JP,et al.Clinical Analysis of Noninvasive Mechanical Ventilation on the Treatment of COPD Combined with Respiratory Failure.Progress in Modern Biomedicine,2014,55:1252-1259.
5 Yanagida N,Tomikawa M,Shukuya A,et al.Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.World Allergy Organization Journal,2015,8:1-7.
6 郑辉才,邢崇浩,王晓敏.无创机械通气治疗COPD合并Ⅱ型呼吸衰竭疗效研究.职业与健康,2014,30:2037-2039.
7 Trivedi S,Tibrewala N,Balsara KP.Anaesthetic management of a patient with amyotrophic lateral sclerosis undergoing laparoscopic diaphragmatic pacing.Indian Journal of Anaesthesia,2015,59:683-685.
8 王爽,郑秀艳,孙文华,等.异丙托溴铵与布地奈德对COPD合并Ⅱ型呼吸衰竭患者MDA,SOD,GSH-Px水平及肺功能的影响.现代生物医学进展,2015,15:6512-6515.
9 庞义新.双水平气道正压通气联合舒利迭在老年中重度慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的应用效果观察.中国实用医刊,2015,42:12-14.
10 Kagohashi K,Satoh H,Ohara G,et al.Long-term safety of budesonide/formoterol for the treatment of elderly patients with bronchial asthma.Experimental&Therapeutic Medicine,2014,7:1005-1009.
11 黄怀焕,林俊锋.噻托溴铵加用布地奈德福莫特罗粉吸入剂联合无创通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的效果.中国医药导报,2015,12:91-94.
12 赵高爱.布地奈德联合复方异丙托溴铵溶液雾化吸入治疗支气管哮喘的临床疗效观察.海峡药学,2015,27:234-234.
13 吴苏华,李远华,赖志君.BIPAP联合特布他林雾化吸入治疗COPD伴呼吸衰竭患者临床疗效分析.内科,2015,10:312-314.
14 胡家荣.布地奈德联合特布他林雾化吸入治疗支气管哮喘急性发作疗效观察.吉林医学,2015,36:841-842.
15 Liu FY,Qian YC,Wei L,et al.Bi-level positive airway pressure respirator combined with aerosolization inhalation for the treatment of acute exacerbation of chronic obstructive pulmonary disease accompanied by typeⅡrespiratory failure in the elderly.Journal of Bengbu Medical College,2014,39:198-201.
2 黄满兴.舒利迭联合BiPAP治疗老年COPD合并Ⅱ型呼吸衰竭的临床价值.深圳中西医结合杂志,2015,25:22-23.
3 刘芳英,钱叶长,危蕾,等.双水平正压通气联合雾化吸入在高龄患者慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭治疗中的应用.蚌埠医学院学报,2014,39:195-197.
4 Feng XL,Wang LP,Zhu JP,et al.Clinical Analysis of Noninvasive Mechanical Ventilation on the Treatment of COPD Combined with Respiratory Failure.Progress in Modern Biomedicine,2014,55:1252-1259.
5 Yanagida N,Tomikawa M,Shukuya A,et al.Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.World Allergy Organization Journal,2015,8:1-7.
6 郑辉才,邢崇浩,王晓敏.无创机械通气治疗COPD合并Ⅱ型呼吸衰竭疗效研究.职业与健康,2014,30:2037-2039.
7 Trivedi S,Tibrewala N,Balsara KP.Anaesthetic management of a patient with amyotrophic lateral sclerosis undergoing laparoscopic diaphragmatic pacing.Indian Journal of Anaesthesia,2015,59:683-685.
8 王爽,郑秀艳,孙文华,等.异丙托溴铵与布地奈德对COPD合并Ⅱ型呼吸衰竭患者MDA,SOD,GSH-Px水平及肺功能的影响.现代生物医学进展,2015,15:6512-6515.
9 庞义新.双水平气道正压通气联合舒利迭在老年中重度慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者中的应用效果观察.中国实用医刊,2015,42:12-14.
10 Kagohashi K,Satoh H,Ohara G,et al.Long-term safety of budesonide/formoterol for the treatment of elderly patients with bronchial asthma.Experimental&Therapeutic Medicine,2014,7:1005-1009.
11 黄怀焕,林俊锋.噻托溴铵加用布地奈德福莫特罗粉吸入剂联合无创通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的效果.中国医药导报,2015,12:91-94.
12 赵高爱.布地奈德联合复方异丙托溴铵溶液雾化吸入治疗支气管哮喘的临床疗效观察.海峡药学,2015,27:234-234.
13 吴苏华,李远华,赖志君.BIPAP联合特布他林雾化吸入治疗COPD伴呼吸衰竭患者临床疗效分析.内科,2015,10:312-314.
14 胡家荣.布地奈德联合特布他林雾化吸入治疗支气管哮喘急性发作疗效观察.吉林医学,2015,36:841-842.
15 Liu FY,Qian YC,Wei L,et al.Bi-level positive airway pressure respirator combined with aerosolization inhalation for the treatment of acute exacerbation of chronic obstructive pulmonary disease accompanied by typeⅡrespiratory failure in the elderly.Journal of Bengbu Medical College,2014,39:198-201.