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闵茜, 贺田红, 杨丽, 王玫. 不同氧浓度无创机械通气在慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者中的应用[J]. 实用临床医药杂志, 2023, 27(24): 59-62, 67. DOI: 10.7619/jcmp.20232117
引用本文: 闵茜, 贺田红, 杨丽, 王玫. 不同氧浓度无创机械通气在慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者中的应用[J]. 实用临床医药杂志, 2023, 27(24): 59-62, 67. DOI: 10.7619/jcmp.20232117
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MIN Qian, HE Tianhong, YANG Li, WANG Mei. Application of non-invasive mechanical ventilation with different oxygen concentrations in patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure[J]. Journal of Clinical Medicine in Practice, 2023, 27(24): 59-62, 67. DOI: 10.7619/jcmp.20232117
Citation: MIN Qian, HE Tianhong, YANG Li, WANG Mei. Application of non-invasive mechanical ventilation with different oxygen concentrations in patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure[J]. Journal of Clinical Medicine in Practice, 2023, 27(24): 59-62, 67. DOI: 10.7619/jcmp.20232117
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不同氧浓度无创机械通气在慢性阻塞性肺疾病急性加重期合并Ⅱ型呼吸衰竭患者中的应用

Application of non-invasive mechanical ventilation with different oxygen concentrations in patients with acute exacerbation of chronic obstructive pulmonary disease and type Ⅱ respiratory failure

    摘要
  • 摘要:
    目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并Ⅱ型呼吸衰竭患者无创机械通气中应用不同吸入氧浓度对其血气指标、血清高迁移率族蛋白B1(HMGB1)、白细胞介素-27(IL-27)水平的影响。
    方法 选取收治的152例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象, 按照随机数字表法分为A组(n=76)及B组(n=76)。A组无创机械通气中吸入氧浓度为45%, B组吸入氧浓度为60%。比较2组不同时点的血气指标、血清HMGB1、IL-27水平变化; 记录治疗期间患者并发症的发生情况。
    结果 治疗7 d后, A组动脉血氧分压pa(O2)、pH值水平高于B组, 动脉血二氧化碳分压pa(CO2)水平低于B组，差异有统计学意义(P < 0.05)。治疗1、7 d后, A组血清HMGB1、IL-27水平低于B组，差异有统计学意义(P < 0.05)。治疗期间, 2组患者并发症总发生率比较，差异无统计学意义(P>0.05)。
    结论 与60%吸入氧浓度相比, AECOPD合并Ⅱ型呼吸衰竭患者接受吸入氧浓度为45%的无创机械通气治疗的临床效果更好，患者的血气指标、血清HMGB1和IL-27水平显著改善，且安全性较高。

     

    Abstract:
    Objective To investigate the influence of different fractions of inspired oxygen used in non-invasive mechanical ventilation on blood gas parameters and serum high mobility group box-1 (HMGB1) and interleukin-27 (IL-27) levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type Ⅱ respiratory failure.
    Methods A total of 152 patients with AECOPD and type Ⅱ respiratory failure were selected as the subjects of the study and divided into group A (n=76) and group B (n=76) using a random number table method. The fraction of inspired oxygen used in non-invasive mechanical ventilation in the group A was 45%, while was 60% in the group B. The changes in blood gas parameters, serum HMGB1 and IL-27 levels at different time points were compared between the groups; the occurrence of complications during treatment was recorded.
    Results After 7 days of treatment, the arterial oxygen partial pressure pa(O2) and pH levels in the group A were significantly higher than those in the group B, while the arterial carbon dioxide partial pressure pa(CO2) level was significantly lower than that in the group B (P < 0.05). After 1 day and 7 days of treatment, the serum HMGB1 and IL-27 levels in the group A were significantly lower than those in the group B (P < 0.05). During the treatment period, there was no significant difference in the overall incidence of complications between the two groups (P>0.05).
    Conclusion Compared with 60% inhaled oxygen concentration, AECOPD patients with type Ⅱ respiratory failure receiving non-invasive mechanical ventilation with an inhaled oxygen concentration of 45% have better clinical outcomes. The patients' blood gas indicators, serum HMGB1 and IL-27 levels are significantly improved, and the treatment is relatively safe.

     

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