小剂量肾上腺素联合机械通气在重症哮喘并呼吸衰竭患者急救中的应用效果观察OA

Objective:To observe the application effect of low-dose epinephrine combined with mechan-ical ventilation in emergency treatment of patients with severe asthma and respiratory failure.Methods:Total-ly 118 patients with severe asthma and respiratory failure who were admitted to the hospital from May 2021 to October 2024 were retrospectively selected.According to different emergency treatment plans,patients were assigned to the observation group(n=58,1-week combined treatment with low-dose epinephrine and me-chanical ventilation)and the control group(n=60,1-week conventional treatment such as mechanical venti-lation).R 4.4.3 was used for propensity score matching(PSM)with a caliper value of 0.2.The observation group and the control group were matched at a 1:1 ratio based on baseline data such as gender,age,and body mass index(BMI).After PSM,effective rate of rescue,symptom improvement,hospital stay,pulmonary function[peak expiratory flow(PEF),forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC)],blood gas indicators[partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),oxygen saturation(SaO2)],inflammatory response and oxidative stress markers[procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-17(IL-17),myeloperoxidase(MPO),superoxide dismutase(SOD),glutathione(GSH)],and adverse reactions in the two groups were evaluated.Results:After PSM,52 matched pairs were successfully generated.No sta-tistically significant differences in baseline data including gender,age,BMI,course of disease,hypertension,diabetes,coronary heart disease,and causes of acute attack were observed between the two groups(P>0.05).After PSM,the observation group showed a higher effective rate of rescue and reductions in the disap-pearance time of chest tightness and wheezing,the duration of cough and hospital stay compared with the con-trol group(P<0.05).After PSM,PEF,FEV1,FVC,and FEV1/FVC in both groups after treatment were higher than pre-treatment values.The pre-treatment to post-treatment differences in PEF,FEV1,and FVC were greater in the observation group than in the control group(P<0.05).After PSM,PaO2 and SaO2 in both groups after treatment were higher than pre-treatment values,while PaCO2 was lower than pre-treatment val-ues.The pre-treatment to post-treatment differences in PaO2,PaCO2,and SaO2 were greater in the observa-tion group than in the control group(P<0.05).After PSM,serum levels of PCT,CRP,IL-6,IL-8,IL-17,and MPO in both groups after treatment were lower than pre-treatment levels,while the levels of SOD and GSH were higher than pre-treatment levels.The pre-treatment to post-treatment differences in serum PCT,CRP,IL-6,IL-17,MPO,SOD,and GSH were greater in the observation group than in the control group(P<0.05).The incidence of adverse reactions did not differ significantly between the two groups(P>0.05).Conclusion:Applying low-dose epinephrine combined with mechanical ventilation in emergency treatment of patients with severe asthma complicated by respiratory failure can significantly increase the effective rate of res-cue,improve their pulmonary function and blood gas indicators,and alleviate airway inflammation and oxida-tive stress,demonstrating favorable clinical efficacy.