| Objective: Application of ulinastatin and NIPPV combined treatment of chronic obstructive pulmonary disease with type Ⅱ respiratory failure, through observation of inflammatory factor,blood-gas parameters, pulmonary function, sputum neutrophil change and tracheal intubation rate, to explore its clinical curative effect。Methods: A total of 90 cases of AECOPD with type Ⅱ respiratory failure, were randomly divided into observation group,control group 1 and control group 2, 30 cases in each group。Three groups were given conventional treatment, the observation group in the conventional treatment also application of ulinastatin +NIPPV treatment,the control group 1 in conventional treatment and application of NIPPV therapy,the control group 2 received conventional therapy alone。Determined the inflammation factors(CRP, IL-6, PCT, LTB4), blood-gas parameters, pulmonary function and sputum neutrophil before and after treatment, then count intubation rate。Results: 1、inflammatory factor comparison: the three groups after treatment of CRP, IL-6, PCT, LTB4 concentration were decreased than the same group before treatment, there were statistically significant difference(P < 0.05)。At the same time, the observation group after treatment CRP, IL-6, PCT, LTB4 concentration was significantly decreased than the control group 1 and 2 after treatment, there was significant difference(P < 0.01)。The control group 1 and the control group 2 were compared after treatment, no statistical difference of CRP, IL-6, PCT, LTB4 concentration(P > 0.05)。2、Comparison of blood-gas parameters:the three groups after treatment, PH, PO2, PCO2 were improved compared with the same group before treatment(P < 0.05)。After treatment, three groups of PCO2 showed that the PCO2 of the observation group and the control group 1 were lower than that of the control group 2 significantly, statistical analysis is different(P < 0.05)。The decrease level of PCO2 in the observation group is more obvious than that of the control group 1,the statistical results show that there are significant differences(P < 0.01)。The difference of PH and PO2 in three groups after treatment has some improvement, but no significant difference(P>0.05)。3、Comparison of pulmonary function: after treatment, three groups of FEV1 / FVC%, FEV1% pre compared,the observation group is better than the control group 1 and control group 2,statistical analysis indicated differences(P < 0.05)。While the control group 1 and 2 after treatment have certain improvement, but there was no difference in the results(P > 0.05)。FEV1/FVC%, FEV1%pre after treatment in three groups compared with the same group before treatment, the results showed that only the observation group has obvious increase,there were statistically significant differences(P<0.05), the control group 1 and 2 were elevated, but no significant difference(P>0.05)。4、Sputum neutrophil comparison:compared with the same group before and after treatment, Sputum neutrophil decreased obviously,the difference was significant(P<0.01)。Three groups of treatment, the observation group compared with the control group 1 and the control group 2 was significantly decreased, the difference was significant(P < 0.01), although there was a decline of the control group 1 and control group 2, but the difference was not obvious, there was no statistical significance(P>0.05)。5、Compare the rate of intubation:The observation group,the control group 1 and control group 2 intubation rate were 6.67%,13.33%,16.67%, the result was no significant difference(P>0.05)。Conclusions:1、The inflammatory factor CRP, IL-6, PCT and LTB4 can be used as the objective index of AECOPD inflammation outcome。2、Ulinastatin combined with NIPPV compared with single NIPPV or the conventional treatment, It can significantly improve the inflammation of AECOPD patients with type Ⅱ respiratory failure,correct the retention of carbon dioxide,promote the recovery of pulmonary function in acute stage。3 、 Ulinastatin combined with NIPPV can’t significantly reduce the intubation rate。... |
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