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高流量鼻导管吸氧联合异丙托溴铵对慢性阻塞性肺疾病合并呼吸衰竭患者Th1/Th2平衡及炎症的影响

Effect of high-flow nasal oxygen therapy combined with ipratropium bromide on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease and respiratory failure.

作者信息

Li Ting, Xu Xuefen

机构信息

Ting Li, Department of Geriatric Medicine, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, P.R. China.

Xuefen Xu, Department of Geriatric Medicine, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, P.R. China.

出版信息

Pak J Med Sci. 2024 Oct;40(9):1979-1984. doi: 10.12669/pjms.40.9.10221.

DOI:10.12669/pjms.40.9.10221
PMID:39416610
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11476147/
Abstract

OBJECTIVE

To investigate the effect of a combination of high-flow nasal oxygen therapy (HFNO) and ipratropium bromide (IB) on Th1/Th2 balance and inflammation in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF).

METHODS

A retrospective analysis was conducted on the clinical data of patients with COPD and RF admitted to the Affiliated Nanjing Brain Hospital of Nanjing Medical University from June 2021 to March 2023. A total of 162 patients were included, with 79 patients received respiratory support using HFNO (HFNO group) and 83 patients who were treated using combined HFNO/IB (combined group). Treatment effect, lung function, levels of Th1/Th2, and inflammatory state were compared before and after the treatment.

RESULTS

Total effeicacy of patients in the combined group was significantly higher than that of the HFNO group (<0.05). After the treatment, pulmonary function levels of the two groups was higher than that before the treatment, and was significantly better in the combined group compared to the HFNO group (<0.05). The treatment was associated with a significant increase in the levels of Th1/Th2 in both groups. Post-treatment levels of these indexes in the combined group were markedly higher compared to the HFNO group (<0.05). After the treatment, the inflammatory response of the two groups decreased, and was lower in the combined group that in the HFNO group (<0.05).

CONCLUSIONS

In COPD patients with RF, HFNO combined with IB is efficient in alleviating the inflammatory state of patients, restoring Th1/Th2 balance, and improving lung function compared to HFNO alone.

摘要

目的

探讨高流量鼻导管吸氧(HFNO)联合异丙托溴铵(IB)对慢性阻塞性肺疾病(COPD)合并呼吸衰竭(RF)患者Th1/Th2平衡及炎症的影响。

方法

回顾性分析2021年6月至2023年3月南京医科大学附属南京脑科医院收治的COPD合并RF患者的临床资料。共纳入162例患者,其中79例患者采用HFNO进行呼吸支持(HFNO组),83例患者采用HFNO/IB联合治疗(联合组)。比较治疗前后的治疗效果、肺功能、Th1/Th2水平及炎症状态。

结果

联合组患者的总有效率显著高于HFNO组(<0.05)。治疗后,两组的肺功能水平均高于治疗前,且联合组明显优于HFNO组(<0.05)。治疗使两组的Th1/Th2水平均显著升高。联合组治疗后这些指标的水平明显高于HFNO组(<0.05)。治疗后,两组的炎症反应均降低,联合组低于HFNO组(<0.05)。

结论

在COPD合并RF患者中,与单独使用HFNO相比,HFNO联合IB能有效减轻患者的炎症状态,恢复Th1/Th2平衡,并改善肺功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/3e09cdd287d2/PJMS-40-1979-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/45e09bb5b759/PJMS-40-1979-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/93380c9e6347/PJMS-40-1979-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/3e09cdd287d2/PJMS-40-1979-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/45e09bb5b759/PJMS-40-1979-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/93380c9e6347/PJMS-40-1979-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81d8/11476147/3e09cdd287d2/PJMS-40-1979-g003.jpg

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