喜炎平联合双水平正压无创通气治疗痰热壅肺型AECOPD合并呼吸衰竭与肺炎的疗效及对PCT,sTREM-1和生活质量的影响

发布时间：2018-10-31 17:18

【摘要】：目的:观察喜炎平注射液联合双水平正压无创通气(BiPAP)治疗痰热壅肺型慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭与肺炎的疗效,及对降钙素原(PCT),可溶性髓样细胞触发受体-1(sTREM-1)和生活质量的影响。方法:将150例AECOPD合并呼吸衰竭与肺炎患者按照随机数字表法分为观察组和对照组,各75例。2组均予以吸氧,抗感染,平喘,BiPAP呼吸机辅助通气等常规治疗,观察组在上述治疗基础之上,给予喜炎平注射液治疗,连续治疗10 d。结果:本研究共入选153例患者,1例自行退出,1例不能按照本方案治疗,1例因出现肺性脑病,转入重症监护室(ICU)行有创机械通气治疗,故符合本方案者150例。观察组、对照组总有效率分别为84%,69%,观察组优于对照组(P0.05)。两组肺功能[1 s用力呼气容积(FEV1),呼气峰值流速(PEF)],血气分析(pH,Pa CO_2,PaO_2)和慢性阻塞性肺疾病评估测试(CAT)评分均较治疗前改善,观察组改善优于对照组(P0.05)。治疗后,两组炎症相关因子sTREM-1,PCT水平下降(P0.05)。组间比较,治疗后观察组sTREM-1,PCT血清水平低于对照组(P0.05)。结论:Bi PAP呼吸机辅助通气联合喜炎平注射液治疗痰热壅肺型AECOPD合并呼吸衰竭与肺炎疗效较好,能迅速缓解临床症状,改善呼吸衰竭,提高生活质量和运动耐力,降低血清炎症因子水平。
[Abstract]:Objective: to observe the curative effect of Xiyanping injection combined with double-level positive pressure noninvasive ventilation (BiPAP) in treating acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstruction of chronic obstructive pulmonary disease (COPD) with respiratory failure and pneumonia, and to treat procalcitonin (PCT),. Effects of soluble myeloid cell trigger receptor-1 (sTREM-1) and quality of life. Methods: one hundred and fifty AECOPD patients with respiratory failure and pneumonia were randomly divided into two groups: observation group (n = 75) and control group (n = 75). Both groups were treated with routine therapy such as oxygen inhalation, anti-infection, antiasthmatic, BiPAP ventilator assisted ventilation and so on. On the basis of the above treatment, the observation group was treated with Xiyanping injection for 10 days. Results: a total of 153 patients were enrolled in this study. One patient withdrew himself, one patient could not be treated according to this scheme. One patient was transferred to intensive care unit (ICU) for invasive mechanical ventilation because of pulmonary encephalopathy. The total effective rate of the observation group and the control group were 84 and 69, respectively, and the observation group was superior to the control group (P0.05). Pulmonary function [1 s forced expiratory volume (FEV1), peak expiratory flow rate (PEF)], blood gas analysis (pH,Pa CO_2,PaO_2) and (CAT) score of chronic obstructive pulmonary disease assessment were improved in both groups. The improvement in the observation group was better than that in the control group (P0.05). After treatment, the sTREM-1,PCT level of inflammatory related factors decreased in both groups (P0.05). After treatment, the serum level of sTREM-1,PCT in the observation group was lower than that in the control group (P0.05). Conclusion: Bi PAP ventilator-assisted ventilation combined with Xiyanping injection is effective in the treatment of phlegm-heat obstructive pulmonary AECOPD complicated with respiratory failure and pneumonia. It can relieve clinical symptoms quickly, improve respiratory failure, improve quality of life and exercise endurance. Reduce the level of serum inflammatory factors.
【作者单位】：延安大学附属医院;
【基金】：延安市科学技术发展计划项目(2015KW-09)
【分类号】：R563

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