摘要
目的探究无创神经调节辅助通气(NIV-NAVA)对慢性阻塞性肺疾病(COPD)伴呼吸衰竭患者的疗效。方法抽取2020年1月至2021年3月于太原钢铁(集团)有限公司总医院就诊的86例COPD伴呼吸衰竭患者86例,按随机数字表法分为观察组和对照组,每组43例。对照组实施无创人机协调通气治疗方案,观察组实施NIV-NAVA治疗方案。比较治疗3个月后两组肺功能[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、每分钟最大通气量(MVV)、最大呼气流量(PEF)]、心功能[最大摄氧量(VO_(2)max)、最大公斤摄氧量(VO_(2)max/kg)、氧脉搏(VO/HR)、心率储备(HRR)],比较治疗前及治疗3个月后两组血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))]、细胞因子[血管内皮生长因子(VEGF)、白细胞介素-17(IL-17)、转化生长因子(TGF-β1)]的变化情况。结果治疗3个月后,观察组FEV1、FVC、MVV、PEF、VO_(2)max、VO_(2)max/kg、VO/HR均高于对照组(P均<0.05),观察组HRR低于对照组(P<0.05);两组PaO_(2)、SaO_(2)均较治疗前上升(P均<0.05),且观察组高于对照组(P<0.05);两组PaCO_(2)、VEGF、IL-17、TGF-β1均较治疗前降低(P均<0.05),且观察组低于对照组(P<0.05)。结论NIV-NAVA用于COPD伴呼吸衰竭患者治疗中可取得显著疗效,有助于改善患者的心肺功能,并可有效调节机体中VEGF、IL-17等细胞因子的表达水平。
Objective To investigate the efficacy of non-invasive ventilation with neurally adjusted ventilatory assist(NIV-NAVA)on patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure.Methods The clincal data of 86 patients with COPD complicated by respiratory failure who were treated in General Hospital of Taiyuan Iron and Steel(Group)Co.,Ltd.from January 2020 to March 2021 were respectively analyzed,and they were divided into observation group and control group by random number table method,with 43 cases in each group.The control group received a treatment regimen of non-invasive man-machine coordinated ventilation,and the observation group was given NIV-NAVA treatment regimen.After 3 months of treatment,the lung function,including forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),maximum voluntary ventilation per minute(MVV),peak expiratory flow(PEF),and cardiac function assessed by maximal oxygen uptake(VO_(2)max),maximum kilogram oxygen uptake(VO_(2)max/kg),oxygen pulse(VO/HR),heart rate reserve(HRR)were compared between the two groups.The blood gas indicators,including partial pressure of arterial blood oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SaO_(2))and cytokines,including vascular endothelial growth factor(VEGF),interleukin-17(IL-17),transforming growth factor-β1(TGF-β1),of the two groups were compared before treatment and after 3 months of treatment.Results After 3 months of treatment,FEV1,FVC,MVV,PEF,VO_(2)max,VO_(2)max/kg and VO/HR in observation group were higher than those in control group(all P<0.05),while HRR in observation group was lower than that in control group(P<0.05).After 3 months of treatment,the PaO_(2) and SaO_(2) in the two groups increased,compared with those before treatment(P<0.05).And PaO_(2) and SaO_(2) of observation group were higher than those of control group after 3 months of treatment(P<0.05).After 3 months of treatment,the PaCO_(2),VEGF,IL-17 and TGF-β1 in the two groups decreased,compared to those before treatment(P<0.05),and the above indicators in observation group were significantly lower than those in control group(P<0.05).Conclusions NIV-NAVA can achieve a significant effect in the treatment of patients with COPD and respiratory failure,and can help to improve the cardiopulmonary function,effectively regulate the expression levels of cytokines such as VEGF and IL-17.
作者
武燕萍
Wu Yanping(Department of Respiratory and Critical Care Medicine,General Hospital of Taiyuan Iron and Steel(Group)Co.,Ltd.,Taiyuan 030008,China)
出处
《中国实用医刊》
2021年第19期54-57,共4页
Chinese Journal of Practical Medicine
关键词
慢性阻塞性肺疾病
无创神经调节辅助通气
呼吸衰竭
Pulmonary disease,chronic obstructive
Non-invasive ventilation with neurally adjusted ventilatory assist
Respiratory failure