摘要
目的探讨乌司他丁联合还原型谷胱甘肽治疗对慢性阻塞性肺疾病急性加重(AECOPD)合并Ⅱ型呼吸衰竭患者肺功能、呼吸力学及氧化应激指标的影响。方法选择2019年12月至2020年11月榆林市星元医院收治的70例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象,采用随机数表法将患者分为观察组和对照组各35例。对照组患者给予乌司他丁治疗,观察组患者在对照组治疗的基础上联合还原型谷胱甘肽治疗,治疗1周后比较两组患者的疗效,以及治疗前后肺活量(FVC)、一秒用力呼气容积(FEV_(1))、第一秒用力呼气容积占用力肺活量百分比(FEV_(1)/FVC)、吸气阻力(Ri)、气道峰压(PIP)、平台压(Pplat)、内源性呼气末正压(PEEPi)、丙二醇(MDA)、谷胱甘肽过氧化物(GSH)和超氧化物歧化酶(SOD)水平,并统计两组患者治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为97.14%,明显高于对照组的77.14%,差异有统计学意义(P<0.05);治疗后,两组患者的FVC、FEV_(1)、FEV_(1)/FVC均升高,且观察组分别为(3.87±0.21)L、(78.31±4.11)L、(64.31±3.76)%,明显高于对照组的(3.31±0.16)L、(67.51±5.09)L、(54.41±3.98)%,差异均有统计学意义(P<0.05);治疗后,两组患者的Ri、PIP、Pplat、PEEPi均降低,且观察组分别为(9.13±1.21)cmH_(2)O、(21.09±3.22)cmH_(2)O、(15.31±2.65)cmH_(2)O、(3.89±0.76)cmH_(2)O,明显低于对照组的(14.61±1.87)cmH_(2)O、(25.71±5.11)cmH_(2)O、(20.54±3.28)cmH_(2)O、(5.12±0.41)cmH_(2)O,差异均有统计学意义(P<0.05);治疗后,两组患者的MDA、GSH均降低,且观察组分别为(5.69±0.71)nmol/L、(6.89±1.09)mg/L,明显低于对照组的(7.34±0.67)nmol/L、(10.54±2.11)mg/L,SOD升高,且观察组为(28.19±4.18)U/L,明显高于对照组的(20.41±5.01)U/L,差异均有统计学意义(P<0.05);两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论乌司他丁联合还原型谷胱甘肽治疗AECOPD合并Ⅱ型呼吸衰竭可有效改善患者的肺功能、呼吸力学指标,减轻氧化应激反应,临床应用效果显著且安全性高。
Objective To investigate the effect of ulinastatin combined with reduced glutathione on pulmonary function,respiratory mechanics,and oxidative stress in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with typeⅡrespiratory failure.Methods Seventy patients of AECOPD complicated with typeⅡrespiratory failure from December 2019 to November 2020 were selected and randomly divided into two groups,with 35 patients in each group.The patients in the control group were treated with ulinastatin,and those in the observation group were treated with reduced glutathione on the basis of the treatment in the control group.The curative effects were compared.The vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),ratio of FEV_(1) to FVC(FEV_(1)/FVC),inspiratory resistance(RI),peak airway pressure(PIP),plateau pressure(Pplat),endogenous positive end expiratory pressure(PEEPi),propylene glycol(MDA),glutathione peroxide(GSH),and superoxide dismutase(SOD)were recorded before and after treatment.The changes of SOD,the adverse reactions of the two groups during treatment were analyzed.Results The total effective rate of the observation group was 97.14%,which was significantly higher than 77.14%of the control group(P<0.05).After treatment,FVC,FEV_(1),FEV_(1)/FVC of the two groups were increased,and the levels in the observation group were(3.87±0.21)L,(78.31±4.11)L,(64.31±3.76)%,significantly higher than(3.31±0.16)L,(67.51±5.09)L,(54.41±3.98)%in the control group(P<0.05).After treatment,RI,PIP,Pplat,and PEEPi decreased in both groups,and the levels in the observation group were(9.13±1.21)cmH_(2)O,(21.09±3.22)cmH_(2)O,(15.31±2.65)cmH_(2)O,(3.89±0.76)cmH_(2)O,significantly lower than(14.61±1.87)cmH_(2)O,(25.71±5.11)cmH_(2)O,(20.54±3.28)cmH_(2)O,(5.12±0.41)cmH_(2)O of the control group(P<0.05).After treatment,MDA and GSH in the two groups decreased,and the levels in the observation group were(5.69±0.71)nmol/L,(6.89±1.09)mg/L,significantly lower than(7.34±0.67)nmol/L,(10.54±2.11)mg/L in the control group;SOD in the two groups increased,and the level in the observation group was(28.19±4.18)U/L,significantly higher than(20.41±5.01)U/L in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion Ulinastatin combined with reduced glutathione in the treatment of AECOPD complicated with type Ⅱ respiratory failure has significant effect,which can effectively improve the lung function and respiratory mechanics index,reduce oxidative stress reaction,with remarkable clinical application effect and high safety.
作者
王阿梅
刘晓荣
王艳
WANG A-mei;LIU Xiao-rong;WANG Yan(First Department of Internal Medicine,Yulin Xingyuan Hospital,Yulin 719000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第11期1383-1386,共4页
Hainan Medical Journal
关键词
慢性阻塞性肺疾病急性加重
Ⅱ型呼吸衰竭
乌司他丁
还原型谷胱甘肽
呼吸力学
肺功能
氧化应激指标
Acute exacerbation of chronic obstructive pulmonary disease
Type Ⅱ respiratory failure
Ulinastatin
Reduced glutathione
Respiratory mechanics
Lung function
Oxidative stress index
