Sun Jielu, Xu Xinkai, Wang Fang
Jielu Sun, Department of Respiratory and Critical Care Medicine, First People's Hospital of Yongkang City, 599 Jinshan West Road, Yongkang, Zhejiang Province 321300, P.R. China.
Xinkai Xu, Department of Respiratory and Critical Care Medicine, First People's Hospital of Yongkang City, 599 Jinshan West Road, Yongkang, Zhejiang Province 321300, P.R. China.
Pak J Med Sci. 2025 Apr;41(4):1157-1163. doi: 10.12669/pjms.41.4.11507.
Mechanical ventilation, such as noninvasive positive pressure ventilation (NIPPV), is often used to relieve the symptoms of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but its treatment effect is limited. This study explored the application effect of NIPPV combined with budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) in AECOPD.
The clinical records of 152 patients with AECOPD treated in the First People's Hospital of Yongkang City from March 2023 to March 2024 were retrospectively selected and grouped based on the ventilation method used: simple NIPPV treatment (n=78) and NIPPV combined with BGF MDI (n=74). The primary outcome was improvement in oxygenation; the secondary outcomes were the recovery of body function and levels of inflammatory markers.
After two weeks of treatment, the arterial partial pressure of carbon dioxide (PaCO2) in the combination group was significantly lower than in the NIPPV group, while the arterial partial pressure of oxygen (PaO2) and oxygenation index (OI) were significantly higher (P<0.05). The COPD Assessment Test (CAT) and St George's Respiratory Questionnaire (SGRQ) scores of the combined group were significantly lower, while the 6-minute walking test (6MWT) score was higher compared to the NIPPV group (P<0.05). The levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in the combined group were significantly lower compared to the NIPPV group (P<0.05).
NIPPV combined with BGF MDI has higher benefits than NIPPV alone for treating patients with AECOPD.
机械通气,如无创正压通气(NIPPV),常用于缓解慢性阻塞性肺疾病急性加重(AECOPD)的症状,但其治疗效果有限。本研究探讨了NIPPV联合布地奈德/格隆溴铵/富马酸福莫特罗定量吸入器(BGF MDI)在AECOPD中的应用效果。
回顾性选取2023年3月至2024年3月在永康市第一人民医院接受治疗的152例AECOPD患者的临床记录,并根据所采用的通气方法进行分组:单纯NIPPV治疗组(n = 78)和NIPPV联合BGF MDI组(n = 74)。主要结局是氧合改善情况;次要结局是身体功能恢复情况和炎症标志物水平。
治疗两周后,联合组的动脉血二氧化碳分压(PaCO2)显著低于NIPPV组,而动脉血氧分压(PaO2)和氧合指数(OI)显著高于NIPPV组(P<0.05)。联合组的慢性阻塞性肺疾病评估测试(CAT)和圣乔治呼吸问卷(SGRQ)评分显著低于NIPPV组,而6分钟步行试验(6MWT)评分高于NIPPV组(P<0.05)。联合组的C反应蛋白(CRP)和白细胞介素-6(IL-6)水平显著低于NIPPV组(P<0.05)。
对于治疗AECOPD患者,NIPPV联合BGF MDI比单独使用NIPPV具有更高的益处。