目的 探讨无创机械通气治疗对老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴呼吸衰竭患者α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,αHBDH)、β-内啡肽(β-endorphin,β-EP)、金属蛋白酶9(matrix metalloprotein-9,MMP-9)及组织抑制因子-1(tissueinhibitor of metallo proteinase-1,TIMP-1)的影响。方法 选择76例老年COPD伴呼吸衰竭患者为研究对象,随机分为两组。对照组予以噻托溴铵治疗,实验组在对照组基础上予以无创机械通气治疗,对比两组治疗前后α-HBDH、β-EP、MMP-9及TIMP-1 的改善情况。结果 治疗前,两组患者的各项指标差异均无统计学意义;治疗后,实验组的αHBDH、β-EP、MMP-9、TIMP-1 水平均低于对照组,差异有统计学意义(P＜0.05);实验组6 min步行距离较对照组延长,圣乔治呼吸问卷评分较对照组降低,差异有统计学意义(P＜0.05)。结论 无创机械通气治疗老年COPD伴呼吸衰竭可有效降低αHBDH、β-EP、MMP-9及TIMP-1水平,促进病情缓解。
Abstract
Objective To explore the effect of non-invasive mechanical ventilation therapy on levels of α-hydroxybutyrate dehydrogenase (αHBDH), β-endorphin (β-EP), metalloproteinase-9 (MMP-9) and tissue inhibitory factor-1 (TIMP-1) in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure.Methods Seventy-six cases of elderly patients with COPD and respiratory failure were selected as the subjects, who were randomly and equally divided into two groups. The control group was treated with tiotropium bromide, while the experimental group was additionally treated with non-invasive mechanical ventilation. The levels ofα-HBD, β-EP, MMP-9 and TIMP-1 were compared between two groups.Results After treatment, levels ofα-HBDH and β-EP were lower in the experimental group than in the control group, respectively, so were the levels of MMP-9 and TIMP-1, with statistically significant significance(P<0.05). After treatment, the walking distance of the experimental group was longer than that of the control group, and the St. George’s breathing questionnaire score was lower than that of the control group, with statistically significant difference(P<0.05).Conclusions Non-invasive mechanical ventilation used for elderly patients with COPD and respiratory failure can effectively reduce the levels of αHBDH, β-EP, MMP-9 and TIMP-1, thereby promoting the relief of patients’ conditions.
关键词
无创机械通气 /
慢性阻塞性肺疾病 /
呼吸衰竭
Key words
non-invasive mechanical ventilation /
chronic obstructive pulmonary disease /
respiratory failure
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