纤支镜气道灌洗对成人重症肺炎呼吸功能、炎症应激程度的影响

摘要

Objective: To study the effect of bronchofiberscope airway lavage on respiratory function and inflammatory stress level in adults with severe pneumonia.Methods: A total of 80 adults with severe pneumonia treated in our hospital between July 2011 and March 2015 were collected, and after the treatment process and auxiliary examination results were retrospectively analyzed, they were divided into control group (n=45) who accepted conventional treatment and observation group (n=35) who accepted bronchofiberscope airway lavage.Before and after treatment, the spirometer was used to test the respiratory function of two groups of patients;ELISA method was used to detect serum inflammatory factor levels;RIA method was used to detect serum stress index levels.Results: Before treatment, differences in serum levels of inflammatory cytokines and stress indexes were not statistically significant between two groups of patients (P>0.05);after treatment, respiratory function parameters FEV1, VA, FEF25-75, FEF50% and FEF75% levels of observation group were significantly higher than those of control group (P<0.05), serum HMGB1, IL-2, IFN-γ, Cor, ADR and NADR levels were significantly lower than those of control group while IL-13 level was significantly higher than that of control group (P<0.05).Conclusions: Bronchofiberscope airway lavage can optimize the respiratory function and reduce systemic inflammatory and stress response in adults with severe pneumonia.%目的:研究纤支镜气道灌洗对成人重症肺炎呼吸功能、炎症应激程度的影响.方法:收集2011年7月~2015年3月间四川省资阳市雁江区中医医院收治的成人重症肺炎患者80例,回顾性分析治疗过程及辅助检查结果,分为接受常规治疗的对照组45例、接受纤支镜气道灌洗的观察组35例.治疗前后,采用肺功能仪检测两组患者的呼吸功能;采用ELISA法检测血清中炎症因子的含量;采用放射免疫法检测血清中应激指标的含量.结果:治疗前,两组患者血清炎症因子、应激指标含量的差异无统计学意义(P>0.05),治疗后,观察组患者的呼吸功能参数FEV1、VA、FEF25-75、FEF50%、FEF75%水平高于对照组患者(P<0.05),血清中HMGB1、IL-2、IFN-γ、Cor、ADR、NADR的含量显著低于对照组患者,IL-13的含量显著高于对照组患者(P<0.05).结论:纤支镜气道灌洗可优化成人重症肺炎患者的呼吸功能,降低全身炎症及应激反应.