Objective To investigate the effect of Bi-level positive airway pressure ( BiPAP) combined with tiotropium bromide on elderly patients with stable chronic obstructive pulmonary disease ( COPD) and its influence on lung function,prealbumin ( PAB) and inflammatory factors. Methods Seventy-eight patients with stable COPD from April 2009 to December 2013 in our hospital were selected as the research object,and randomly divided into tiotropium-group and tiotropium+BiPAP group,39 cases in each group. Life quality scoring,dyspnea grade,and COPD assessment test ( CAT) were compared between the two groups. The changes of lung function,prealbumin and inflammatory factor in both groups were compared. Results Before treatment, there was no significant difference in the quality of life score,dyspnea grade,CAT score,lung function,inflammatory factors and PAB (P>0.05). After treatment,three di-mensions of quality of life score,dyspnea grade and CAT score decreased significantly (P0.05). Lung function index (FEV1% pre,FEV1,FEV1/FVC),blood gas analysis indexes (PaO2),inflammatory fac-tor (IL-10 and PAB) of patients significantly elevated after treatment (P0.05 );治疗后,生活质量三个维度评分、呼吸困难分级和CAT评分值均明显降低(P0.05);肺功能指标FEV1、FEV1% pre、FEV1/FVC、血气分析指标PaO2、炎性因子IL-10及PAB均升高(P<0.05);而PaCO2、IL-4、IL-6、IL-8、TNF-α和hs-CRP降低(P<0.05),且BiPAP+噻托溴铵组患者上述指标的改善程度明显优于噻托溴铵组(P<0.05). 结论 BiPAP联合噻托溴铵对老年稳定期COPD患者具有明显的临床疗效,且能够改善肺功能及血气分析指标,降低炎症反应和纠正低PAB血症.
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