肠内营养对慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者肺功能及内皮素1的影响

摘要

Objective To investigate the effect of enteral nutrition on pulmonary function and endothe-lin-1 ( ET-1 ) of patients with chronic obstructive pulmonary disease ( COPD ) combined with type Ⅱrespiratory failure.Methods A total of 178 cases of COPD combined with type Ⅱ respiratory failure,who were treated in Dujiangyan City Hospital of Traditional Chinese Medicine from Oct.2012 to Sep.2014 were selected in the study and were divided into the treatment group of 90 cases and the control group of 88 cases according to random number table method.The treatment group was treated with enteral nutrition.The control group was treated with free diet,and the changes of lung function index and ET-1 of the two groups before and after treatment were observed.Results After treatment,the scores of forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1%,FEV1/FVC of the treatment group were significantly higher than the control group [ ( 1.48 ±0.61 ) L vs ( 1.22 ±0.53 ) L, ( 3.09 ±1.38 ) L vs ( 2.75 ± 1.30) L,(51.24 ±21.41)% vs (45.24 ±16.52)%,(57.25 ±15.39)% vs (50.93 ±17.68)%], PaCO2 and ET-1 were significantly lower than the control group [(46.1 ±1.9) kPa vs (61.3 ±2.8) kPa, (46.4 ±4.7) ng/L vs (72.1 ±4.4) ng/L],PaO2 were significantly higher than the control group [(70.6 ±5.1) kPa vs(61.3 ±5.6) kPa] (P<0.05),there was no significant difference in pH between the two groups[(7.35 ±0.02) vs (7.31 ±0.36),P>0.05].Conclusion The enteral nutrition has good clinical curative effect in improving lung function of patients with COPD combined with typeⅡrespiratory failure.%目的：探讨肠内营养对慢性阻塞性肺疾病（ COPD）合并Ⅱ型呼吸衰竭患者肺功能及内皮素1的影响。方法选取2012年10月至2014年9月在都江堰市中医医院就诊的 COPD合并Ⅱ型呼吸衰竭患者178例为研究对象，按照随机数字表法分为治疗组（90例）和对照组（88例），分别给予肠内营养和自由饮食，观察两组治疗前后的肺功能指标及内皮素1的变化。结果经治疗后，治疗组的第一秒用力呼气量（ FEV1）、用力肺活量（ FVC）、FEV1％预测值、 FEV1／FVC 显著高于对照组[（1.48±0.61） L比（1.22±0.53） L、（3.09±1.38） L 比（2.75±1.30） L、（51.24±21.41）％比（45.24±16.52）％、（57.25±15.39）％比（50.93±17.68）％]，治疗后治疗组动脉血二氧化碳分压、内皮素1水平显著低于对照组[（46.1±1.9） kPa比（61.3±2.8） kPa，（46.4±4.7） ng／L比（72.1± 4.4） ng／L]、动脉血氧分压显著高于对照组[（70.6±5.1） kPa比（61.3±5.6） kPa]，差异有统计学意义（ P＜0.05）。两组 pH 比较差异无统计学意义[（7.35±0.02）比（7.31±0.36）， P ＞0.05]。结论肠内营养在改善COPD合并Ⅱ型呼吸衰竭患者肺功能方面具有较好的临床疗效。