摘要
目的探讨参附注射液对慢性阻塞性肺病急性加重期合并血清甲状腺激素水平低下的老年患者的临床疗效和作用机制。方法将42例慢性阻塞性肺疾病急性加重期(AECOPD)合并甲状腺激素水平低下且伴有呼吸衰竭和/或心力衰竭的老年患者分为治疗组(22例)和对照组(20例)。在相同的常规治疗基础上,治疗组加用参附注射液50ml静脉滴注(加入5%葡萄糖液或0.9%氯化钠溶液250ml静脉滴注),1次/d,疗程均为2周。观察两组临床疗效以及治疗前后的血气分析、心肺功能及甲状腺激素水平变化。结果治疗组总有效率为91%(20/22),对照组为80%(16/20),治疗组显著高于对照组(P<0.05)。与治疗前比较,两组治疗后动脉血气、心肺功能参数及甲状腺激素水平均有明显改善(P均<0.05),且治疗组动脉血氧分压、二氧化碳分压、血氧饱和度、第1秒用力呼气容积、左心射血分数、舒张早期流速峰/舒张晚期流速峰、BNP及总三碘甲状腺原氨酸均较对照组明显改善(P均<0.05)。结论参附注射液通过纠正AECOPD患者缺氧和二氧化碳潴留,改善心肺功能,提高甲状腺激素水平,促进患者及早康复。
Objective To investigate the clinical therapeutic effect and mechanism of Shenfu injection on geriatric patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD） and low serum level of thyroid hormone. Methods Forty-two elderly AECOPD patients with respiratory and/or heart failure and low serum level of thyroid hormone were randomly divided into the treatment group （22 cases） and control group （20 cases）. The patients in the treatment group received 50 ml Shenfn injection and 5% glucose or normal saline intravenous drip once daily for 2 weeks, while the patients in the control group received conventional treatment only. The clinical therapeutic effects were observed, and the blood gas analysis, cardiorespiratory function parameters and serum levels of thyroid hormones in both groups were measured before and after the therapy. Results The total effective rate in the treatment group was much higher than that in the control group （91% vs 80%, P〈0.05）. Afterthe therapy, the blood gas analysis, cardiorespiratory function parameters and serum levels of thyroid hormones in both groups all showed significant differences as compared to those before the therapy （all P 〈 0.05）, and partial pressure of oxygen, arterial partial pressure of C02, arterial oxyhemoglobin saturation, forced expiratory volume in the 1st second, left ventricular ejection fraction, the mitral ratio of peak early to late diastolic filling velocity （E/A）, B-type natriuretic peptide and total triiodothyronine in the treatment group were much better than those in the control group （all P 〈 0.05）. Conclusion Shenfu injection can correct hypoxia and carbon dioxide retention, ameliorate cardiorespiratory function,improve thyroid hormone levels, thereby bring a definite clinical curative effect in elderly AECOPD patients.
出处
《中华危重症医学杂志（电子版）》
CAS
2013年第2期15-19,共5页
Chinese Journal of Critical Care Medicine:Electronic Edition
关键词
参附注射液
肺疾病
慢性阻塞性
甲状腺激素类
Shenfu injection
Pulmonary disease, chronic obstructive
Thyroid hormones
