2023 年第 8 期 第 18 卷

特布他林雾化吸入联合无创-有创序贯通气治疗慢性阻塞性肺疾病急性加重期患者的效果及对肺功能和相关因子水平的影响

Effect of atomized inhalation of terbutaline combined with non-invasive-invasive sequential ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease and its impact on lung function and related factor level

作者：李敬萍1阿孜古丽·买买提吐尔逊1卡迪丽娅·阿不都卫力1罗倩2

英文作者：Li Jingping1 Aziguli Maimaitituerxun1 Kadiliya Abuduweili1 Luo Qian2

单位：1新疆维吾尔自治区人民医院呼吸与危重症医学科，乌鲁木齐830000；2新疆生产建设兵团医院呼吸内科，乌鲁木齐830002

英文单位：1Department of Respiratory and Critical Care Medicine People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830000 China; 2Department of Respiratory Medicine Xinjiang Production and Construction Corps Hospital Urumqi 830002 China

关键词：慢性阻塞性肺疾病急性加重期；特布他林；无创-有创序贯通气；白细胞介素；髓过氧化物酶；嗜酸性粒细胞阳离子蛋白

英文关键词：Acuteexacerbationofchronicobstructivepulmonarydisease;Terbutaline;Non-invasion-invasivesequentialventilation;Interleukin;Myeloperoxidase;Eosinophilcationicprotein

• 摘要：

• 目的 探讨特布他林雾化吸入联合无创-有创序贯通气治疗慢性阻塞性肺疾病急性加重期（AECOPD）患者的效果及对肺功能和血清白细胞介素8（IL-8）、髓过氧化物酶（MPO）、嗜酸性粒细胞阳离子蛋白（ECP）水平的影响。方法 选取2020年8月至2022年8月诊治的104例AECOPD患者作为研究对象，按照随机数字表法分为对照组（予以特布他林雾化吸入联合常规有创通气治疗）与观察组（予以特布他林雾化吸入联合无创-有创序贯通气治疗），各52例，2组均持续治疗7 d。比较2组患者临床总有效率、肺功能［第1秒用力呼气容积（FEV1）、FEV1占预计值百分比（FEV1%）、FEV1/用力肺活量（FVC）比值］、血气分析指标［动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）］、呼出气一氧化氮（FeNO）、IL-8、MPO、ECP及撤机失败、二次插管、呼吸机相关性肺炎(VAP)发生率。结果 观察组总有效率高于对照组［96.2%（50/52）比82.7%（43/52）］（P＜0.05）。治疗后，观察组FEV1、FEV1%、FEV1/FVC比值、PaO2均高于对照组，而PaCO2、FeNO、IL-8、MPO、ECP均低于对照组（均P＜0.05）。观察组撤机失败率、二次插管率、VAP发生率均低于对照组［0比7.7%（4/52）、0比7.7%（4/52）、1.9%（1/52）比13.5%（7/52）］，差异均有统计学意义（均P<0.05）。结论 特布他林雾化吸入联合无创-有创序贯通气治疗AECOPD具有较为理想效果，不仅能改善患者肺功能，并且能降低IL-8、MPO、ECP水平。

• Objective To investigate the effect of atomized inhalation of terbutaline combined with non-invasive-invasive sequential ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and its impact on lung function and serum levels of interleukin-8, myeloperoxidase(MPO) and eosinophil cationic protein(ECP). Methods  From August 2020 to August 2022, 104 patients with AECOPD diagnosed and treated were selected as the research objects. According to the random number table method, they were divided into the control group(treated with atomized inhalation of terbutaline combined with conventional invasive ventilation) and the observation group(treated with atomized inhalation of terbutaline combined with non-invasive-invasive sequential ventilation), with 52 cases in each group, both groups were treated continuously for 7 d. The total clinical effective rate, pulmonary function［forced expiratory volume in the first second(FEV1), ratio of FEV1 to percentage of expected value(FEV1%), FEV1/forced vital capacity(FEV1/FVC) ratio］, blood gas analysis indicators［arterial partial pressure of oxygen(PaO2), arterial partial pressure of carbon dioxide(PaCO2)］, exhaled nitrogen oxide(FeNO), interleukin-8, MPO, ECP and the incidence rates of weaning failure, secondary intubation and ventilator-associated pneumonia(VAP) were compared. Results The total effective rate in the observation group was higher than that in the control group［96.2%（50/52） vs 82.7%（43/52）］(P<0.05). After treatment, the FEV1, FEV1%, FEV1/FVC and PaO2 in the observation group were higher than those in the control group, while the PaCO2, FeNO, interleukin-8, MPO and ECP in the observation group were lower than those in the control group(all P<0.05). The incidence rates of weaning failure, secondary intubation and VAP in the observation group were lower than those in the control group(all P<0.05). Conclusion Atomized inhalation of terbutaline combined with non-invasive-invasive sequential ventilation in the treatment of AECOPD has an ideal effect, not only improving patients′ lung function, but also reducing the levels of interleukin-8, MPO and ECP.