布地格福吸入气雾剂联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的临床研究OA北大核心CSTPCD

Objective To observe the application effect of budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with non-invasive positive pressure ventilation(NPPV)in the treatment of patients with chronic obstructive pulmonary disease(COPD)complicated with respiratory failure undergoing and the influence on blood gas,pulmonary function and airway resistance.Methods Adopting retrospective study,patients with COPD complicated with respiratory failure were divided into control group and treatment group.All patients in both groups were treated with NPPV on the basis of routine treatments such as resolving phlegm,anti-infection and nutritional support,and the control group was treated with ipratropium bromide inhalation spray(2 sprays every time,three times a day),and the treatment group was given Budigefu inhalation aerosol(2 inhalations every time,twice a day).Patients in both groups were continuously treated for 2 weeks.Clinical efficacy was evaluated,and the arterial oxygen saturation(SaO2),partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),FEV1/FVC,respiratory resistance at 5 Hz(R5),respiratory impedance at 5 Hz(Z5),resonant frequency(Fres),serum interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)were compared before and after treatment in two groups,and adverse drug reactions were recorded in two groups.Results There were 46 cases in control group and 54 cases in treatment group.After treatment,the total effective rates in treatment group and control group were 96.30％(52 cases/54 cases)and 82.61％(38 cases/46 cases),SaO2 values were(88.75±6.08)and(82.25±5.64)mmHg,PaO2 values were(72.26±7.73)and(59.96±4.28)mmHg,PaCO2 values were(51.02±8.18)and(58.48±7.76)mmHg,FEV,values were(2.07±0.51)and(1.75±0.42)L,FVC values were(2.48±0.55)and(2.16±0.48)L,FEV1/FVC values were(71.28±9.42)％and(63.34±8.03)％,R5 values were(102.64±17.14)％and(136.21±15.77)％,Z5 values were(105.41±16.25)％and(138.51±18.44)％,Fres values were(13.94±2.74)and(17.51±2.48)Hz,IL-6 levels were(3.64±0.57)and(4.83±0.62)μg·L-1,CRP levels were(8.06±2.15)and(10.34±2.26)mg·L-1,PCT levels were(0.57±0.16)and(0.86±0.25)ng·mL-1,all with significant difference(all P＜0.05).The total incidence rates of adverse drug reactions in treatment group and control group were 12.96％(7 cases/54 cases)and 8.70％(4 cases/46 cases),with no significant difference(P＞0.05).Conclusion Budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol has an exact efficacy in the treatment of COPD patients with respiratory failure undergoing NPPV,and it can effectively improve the blood gas,promote the pulmonary function recovery and reduce the airway resistance,and the mechanism may be related to its better alleviation of airway inflammation.