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噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响
The effect of tiotropium bromide combined with noninvasive ventilator on blood gas indicators, respiratory function and inflammatory factors in pneumoconiosis complicated with respiratory failure patients
- 保健医学研究与实践 2020年17卷第4期 页码：41-46
- 作者机构：
1. 安徽省青阳县人民医院呼吸内科
2. 华南农业大学医院
- 作者简介：
- 基金信息：广东省省级科技计划项目（2015A020224030）
DOI：
中图分类号： R135.2;R563.8纸质出版日期：2020，
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[1]王庭,童峰.噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响[J].保健医学研究与实践,2020,17(04):41-46.
Wang Ting, Tong Feng. The effect of tiotropium bromide combined with noninvasive ventilator on blood gas indicators, respiratory function and inflammatory factors in pneumoconiosis complicated with respiratory failure patients[J]. Health Medicine Research and Practice, 2020,17(4):41-46.
[1]王庭,童峰.噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响[J].保健医学研究与实践,2020,17(04):41-46. DOI：
Wang Ting, Tong Feng. The effect of tiotropium bromide combined with noninvasive ventilator on blood gas indicators, respiratory function and inflammatory factors in pneumoconiosis complicated with respiratory failure patients[J]. Health Medicine Research and Practice, 2020,17(4):41-46. DOI：
摘要
目的探讨噻托溴铵联合无创呼吸机治疗对尘肺并发呼吸衰竭患者血气指标、呼吸功能及炎性因子水平的影响。方法选取2018年4月-2019年11月安徽省某医院收治的110例尘肺并发呼吸衰竭患者为研究对象
采用随机数字表法分为对照组（55例）和研究组（55例）。对照组患者采用噻托溴铵治疗
研究组患者采用噻托溴铵联合无创呼吸机治疗
2组患者均持续治疗14 d。比较2组患者临床效果;比较2组患者治疗前后心率、呼吸频率、血气指标[动脉血氧分压（Pa O
2
）、动脉二氧化碳分压（Pa CO
2
）、血氧饱和度（Sa O
2
）及血浆p H值]、呼吸力学指标[气道峰压(P
peak
)、静态顺应性（Cst）及气道阻力（RAW）]、炎性因子指标[C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-27 （IL-27）及降钙素原（PCT）]
。结果治疗前
2组患者心率
呼吸频率
Pa O
2
Pa CO
2
Sa O
2
及血浆p H值比较
差异均无统计学意义（P
>
0.05）;治疗后
2组患者心率、呼吸频率及Pa CO
2
均明显低于治疗前
且研究组患者低于对照组
差异均有统计学意义（P
<
0.05）;治疗后
2组患者Pa O
2
及Sa O
2
均明显高于治疗前
且研究组患者高于对照组
差异均有统计学意义（P
<
0.05）。治疗前
2组患者P
peak
Cst及RAW比较
差异均无统计学意义（P
>
0.05）。治疗后
2组患者P
peak
及RAW均明显低于治疗前
且研究组患者低于对照组
差异均有统计学意义（P
<
0.05）;治疗后
2组患者Cst明显高于治疗前
且研究组患者高于对照组
差异有统计学意义（P
<
0.05）。治疗前
2组患者CRP
TNF-α
IL-27及PCT水平比较
差异均无统计学意义（P
>
0.05）。治疗后
2组患者CRP
TNF-α
IL-27及PCT水平均明显低于治疗前
且研究组患者低于对照组
差异均有统计学意义（P
<
0.05）。对照组患者发生不良反应5例（口咽干燥2例、头晕2例、恶心1例）
不良反应发生率为9.09%;研究组患者发生不良反应5例（口咽干燥1例、头晕2例、恶心1例、胃部胀气1例）
不良反应发生率为9.09%。对照组患者治疗总有效率为72.73%
研究组患者治疗总有效率为96.36%
二者相较
差异有统计学意义（P
<
0.05）。结论噻托溴铵联合无创呼吸机治疗可有效改善尘肺并发呼吸衰竭患者血气指标、呼吸功能
减轻炎性反应
疗效显著
值得推广应用。
Abstract
Objective To investigate the effects of tiotropium bromide combined with non-invasive ventilator therapy on blood gas index
respiratory function and inflammatory factor levels in patients with pneumoconiosis complicated with respiratory failure. Methods A total of 110 patients with pneumoconiosis and respiratory failure who were admitted to a hospital in Anhui Province from April 2018 to November 2019 were selected as the research subjects. The patients were divided into a control group（55 cases） and a study group（55 cases） using a random number table method. Patients in the control group were treated with tiotropium bromide
patients in the study group were treated with tiotropium bromide combined with non-invasive ventilator
and the patients in both groups were continuously treated for 14 days. Compare the clinical effects of the two groups of patients; compare the heart rate
respiratory rate
and blood gas indexes of the two groups of patients before and after treatment [arterial blood oxygen pressure（PaO
2
）
arterial carbon dioxide pressure（PaCO
2
）
blood oxygen saturation（Sa O
2
）
and plasma p H value]
Respiratory mechanics indicators [peak air pressure(P
peak
)
static compliance（Cst） and airway resistance（RAW）]
inflammatory factor indicators [C reactive protein（CRP）
tumor necrosis factor-α（TNF-α）
Interleukin-27（IL-27） and procalcitonin（PCT）]
. Results Before treatment
there was no significant difference in heart rate
respiratory rate
Pa O
2
Pa CO
2
Sa O
2
and plasma p H between the two groups（P
>
0.05）. After treatment
the heart rate
respiratory rate
and Pa CO
2
of the two groups were significantly lower than before treatment
and the patients in the study group were lower than the control group
and the differences were statistically significant（P
<
0.05）; Pa O
2
and Sa O
2
were significantly higher in the two groups. Before treatment
and the patients in the study group were higher than the control group
the differences were statistically significant（P
<
0.05）; the plasma p H values of the two groups were higher than before treatment
and the difference was not statistically significant（P
>
0.05）. The patients were higher than the control group
and the difference was statistically significant（P
<
0.05）. Before treatment
there was no significant difference in P
peak
Cst and RAW between the two groups（P
>
0.05）. After treatment
the P
peak
and RAW of the two groups were significantly lower than before the treatment
and the patients in the study group were lower than the control group
the differences were statistically significant（P
<
0.05）; the Cst of the two groups was significantly higher than before the treatment
and the study group The patients were higher than the control group
and the difference was statistically significant（P
<
0.05）. Before treatment
there was no significant difference in the levels of CRP
TNF-α
IL-27 and PCT between the two groups of patients（P
<
0.05）. After treatment
the levels of CRP
TNF-α
IL-27 and PCT in the two groups were significantly lower than before treatment
and the patients in the study group were lower than the control group
and the differences were statistically significant（P
>
0.05）. 5 patients in the control group（2 patients with dry oropharynx
2 patients with dizziness
and 1 with nausea）
the incidence of adverse reactions was 9.09%; 5 patients with adverse reactions in the study group（1 patient with dry oropharynx
2 patients with dizziness
1 case of nausea
1 case of flatulence in the stomach）. The incidence of adverse reactions was 9.09%. The total effective number of patients in the control group was 40 and the total effective rate was 72.73%. In the study the total effective rate was 96.36%
the difference was statistically significant（P
<
0.05）. Conclusion Tiotropium bromide combined with non-invasive ventilator therapy can effectively improve the blood gas index and respiratory function
reduce the inflammatory response in patients with pneumoconiosis complicated with respiratory failure
and has significant curative effect. It is worth popularizing and applying.
关键词
噻托溴铵无创呼吸机尘肺并发呼吸衰竭血气指标呼吸功能炎性因子
Keywords
Tiotropium bromideNoninvasive ventilatorPneumoconiosis complicated with respiratory failureBlood gas indicatorRespiratory functionInflammatory factor
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