摘要
目的探讨双水平气道正压通气(Bi-level positive airway pressure,Bi PAP)联合噻托溴铵对老年慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)稳定期患者的疗效及对肺功能、前清蛋白(Prealbumin,PAB)和炎性因子水平的影响。方法选择2009年4月至2013年12月于我院呼吸内科诊治的78例老年COPD患者,按随机数字表法分为噻托溴铵组和Bi PAP+噻托溴铵组,每组39例。利用生活质量评分、呼吸困难分级和COPD评估测试(CAT)比较两组患者的治疗效果,同时对比肺功能、前清蛋白和炎性因子指标的变化。结果治疗前,两组患者生活质量评分的症状维度、活动维度和影响维度、呼吸困难分级、CAT评分值、肺功能指标、炎性因子和PAB比较,差异均无统计学意义(P>0.05);治疗后,生活质量三个维度评分、呼吸困难分级和CAT评分值均明显降低(P<0.05);但与噻托溴铵组比较,Bi PAP+噻托溴铵组患者生活质量评分和CAT得分值的改善效果更为明显(P<0.05),而两组呼吸困难分级比较差异无统计学意义(P>0.05);肺功能指标FEV1、FEV1%pre、FEV1/FVC、血气分析指标Pa O2、炎性因子IL-10及PAB均升高(P<0.05);而Pa CO2、IL-4、IL-6、IL-8、TNF-α和hs-CRP降低(P<0.05),且Bi PAP+噻托溴铵组患者上述指标的改善程度明显优于噻托溴铵组(P<0.05)。结论 Bi PAP联合噻托溴铵对老年稳定期COPD患者具有明显的临床疗效,且能够改善肺功能及血气分析指标,降低炎症反应和纠正低PAB血症。
Objective To investigate the effect of Bi-level positive airway pressure （ BiPAP） combined with tiotropium bromide on elderly patients with stable chronic obstructive pulmonary disease （ COPD） and its influence on lung function,prealbumin （ PAB） and inflammatory factors. Methods Seventy-eight patients with stable COPD from April 2009 to December 2013 in our hospital were selected as the research object,and randomly divided into tiotropium-group and tiotropium＋BiPAP group,39 cases in each group. Life quality scoring,dyspnea grade,and COPD assessment test （ CAT） were compared between the two groups. The changes of lung function,prealbumin and inflammatory factor in both groups were compared. Results Before treatment, there was no significant difference in the quality of life score,dyspnea grade,CAT score,lung function,inflammatory factors and PAB （P〉0.05）. After treatment,three di-mensions of quality of life score,dyspnea grade and CAT score decreased significantly （P〈0.05）,but patients in Bi-PAP＋tiotropium group showed more obvious improvements on quality of life and CAT scores as compared with tiotro-pium group （P〈0.05）. However,no significant difference was found in dyspnea grade between the two groups （P〉0.05）. Lung function index （FEV1% pre,FEV1,FEV1/FVC）,blood gas analysis indexes （PaO2）,inflammatory fac-tor （IL-10 and PAB） of patients significantly elevated after treatment （P〈0.05）,while the PaCO2,IL-4,IL-6,IL-8, TNF-α and hs-CRP significantly decreased （P〈0.05）;The degree of improvements in BiPAP＋tiotropium group was better than that of tiotropium group （ P〈0.05 ） . Conclusion BiPAP combined with tiotropium bromide has obvious curative effect on elderly patients with stable COPD,and can improve the pulmonary function and blood gas analysis in-dex,reduce inflammation and correct the low PAB level.
出处
《实用药物与临床》
CAS
2015年第9期1073-1077,共5页
Practical Pharmacy and Clinical Remedies
关键词
双水平气道正压通气
慢性阻塞性肺疾病
前清蛋白
炎症因子
肺功能
Bi-level positive airway pressure
Chronic obstructive pulmonary disease
Prealbumin
Inflammatory factors
Lung function
