沙丁胺醇与噻托溴铵联合治疗对慢性阻塞性肺疾病急性加重期患者肺功能和呼吸动力学的影响

摘要

目的 探究沙丁胺醇与噻托溴铵联合治疗对慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能和呼吸动力学的影响.方法 选取我院收治的97例AECOPD患者,按随机数字表将AECOPD患者随机分为研究组(48例)和沙丁胺醇组(49例),沙丁胺醇组患者给予常规治疗和沙丁胺醇治疗,研究组患者在沙丁胺醇组治疗基础上给予噻托溴铵治疗,治疗前后检测两组AECOPD患者呼吸动力学指标、肺功能和血气指标变化.结果 与治疗前比较,两组患者治疗后平台压(Pplat)、平均气道压(MPaw)以及气道阻力(Raw)水平均降低、吸气峰值压(PIP)升高(P＜0.05);治疗后研究组患者MPaw、Pplat、Raw水平均低于沙丁胺醇组、PIP高于沙丁胺醇组(P＜0.05).与治疗前比较,两组患者治疗后用力肺活量(FVC)、第1秒钟最大呼气容积(FEV1)、最高呼气流速(PEF)和平均最大呼气流量(MMEF)水平均升高(P＜0.05);治疗后研究组患者FVC、FEV1、PEF和 MMEF水平高于沙丁胺醇组(P均＜0.05).与治疗前比较,两组患者治疗后动脉血氧分压(PaO2)、血氧饱和度(SaO2)、氧合指标(PaO2/FiO2)水平均升高、二氧化碳分压(PaC02)降低(P均＜0.05);治疗后研究组患者Sa02、 PaO2、PaO2/FiO2均高于沙丁胺醇组、PaCO2低于沙丁胺醇组(P均＜0.05).结论 沙丁胺醇与噻托溴铵的联合治疗降低了 AECOPD患者呼吸强度,同时提高了患者肺功能和血氧水平.%Objective To observe the effect of salbutamol combined with tiotropium on pulmonary function, blood gas and respiratory dynamics in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 97 patients with AECOPD were selected and randomly divided into two groups: the research group (48 patients) and the salbutamol group (49 patients). The patients of salbutamol group were treated with conventional therapy and salbutamol. Patients of the research group were treated with salbutamol combined with tiotropium. Before and after treatment, the changes of pulmonary function, blood gas and respiratory dynamics were analyzed. The related mechanism and significance were analyzed. Results Compared with before treatment, the plateau pressure (Pplat), mean airway pressure (MPaw), airway resistance (Raw) of the two groups after treatment were significantly reduced, but peak gas pressure (PIP) increased significantly (P＜0.05). Pplat, MPaw, and Raw in research group after treatment were significantly lower than those in the salbutamol group(P＜0.05). PIP was significantly higher than those in the salbutamol group (P＜0.05). The forced vital capacity (FVC), first seconds maximum expiratory volume (FEV1), peak expiratory flow rate (PEF), the average maximum expiratory flow (MMEF) of the two groups after treatment were significantly increased(P＜0.05). FEV1, FVC, PEF, and MMEF in research group after treatment were significantly higher than those in the salbutamol group (P＜0.05). Compared with before treatment, arterial oxygen partial pressure (PaO2), oxygenation index(PaO2/FiO2), oxygen saturation (Sp02) of the two groups after treatment were significantly increased (P＜0.05), but pressure of carbon dioxide(PaC02)was significantly reduced(P＜0.05), the Sa02, Pa02, and Pa02/Fi02 in research group after treatment were significantly higher than those in the salbutamol group (P＜0.05). The PaC02 was significantly lower than those in the salbutamol group(P＜0.05). Conclusion Salbutamol combined with tiotropium can reduce the respiratory intensity of AECOPD patients and improve the lung function and blood oxygen level at the same time.