摘要
目的探讨纤维支镜下肺灌洗术对煤工尘肺并发慢性阻塞性肺病(COPD)患者肺通气功能、血气指标及炎性因子的影响。方法选取2018年3月至2020年11月我院收治的84例煤工尘肺并发COPD患者,并按随机数字表法分为对照组和观察组,每组42例。对照组给予常规对症治疗,观察组在对照组基础上施行纤维支镜肺灌洗术。比较两组患者肺通气功能、血气指标及炎性因子水平。结果治疗后,两组第1秒用力呼气量(FEV_(1))、用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV_(1)%pred)及动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))水平较治疗前比较差异无统计学意义,且两组间比较差异无统计学意义(P>0.05)。治疗后,两组6 min步行试验(6 MWT)距离较治疗前明显增加(P<0.05),观察组明显高于对照组(P<0.05);治疗后,两组转化生长因子-β_(1)(TGF-β_(1))、基质金属蛋白酶-9(MMP-9)、呼出气一氧化氮(FeNo)水平较治疗前明显降低(P<0.05),且观察组明显低于对照组(P<0.05)。结论纤维支镜下肺灌洗术能够有效减轻煤工尘肺并发COPD患者炎症反应,提高患者运动耐量。
Objective To investigate the effects of bronchofiberoscope lung lavage on lung ventilation function, blood gas indexes and inflammatory factors in patients with coal worker’s pneumoconiosis complicated withchronic obstructive pulmonary disease(COPD). Methods A total of 84 coal worker’s pneumoconiosis patients with COPD who were admitted to ahospital from March 2018 to November 2020 were selected and divided into a control group and an observation group according to a random number table, with 42 cases in each group. The control group was given conventional symptomatic treatment, and the observation group performed bronchoscopy lung lavage on the basis of the control group. The lung ventilation function, blood gas indexes and inflammatory factor levels were compared between the two groups. Results After treatment, the two groups of forced expiratory volume in the first second(FEV_(1)),forced vital capacity(FVC),forced expiratory volume in the first second as a percentage of predicted value(FEV_(1)% pred),arterial oxygen partial pressure(PaO_(2)),and arterial carbon dioxide partial pressure(PaCO_(2)) levels were not evidently different from those before treatment(P>0.05),and there was no significant difference between the two groups(P>0.05). After treatment, the 6-minute walk test distance(6 MWT) of the two groups was evidently higher than that before treatment(P<0.05),and the observation group was evidently higher than that in the control group(P<0.05);the levels of transforming growth factor-β_(1)(TGF-β_(1)),matrix metalloproteinase-9(MMP-9),and exhaled nitric oxide(FeNo) in the two groups were evidently lower than those before treatment(P<0.05),and the observation group were evidently lower than those in control group(P<0.05). Conclusion Bronchofiberoscope lung lavage can effectively reduce the inflammatory response of patients with coal worker’s pneumoconiosis complicated with COPD and improve the exercise tolerance of patients.
作者
冉庆学
钟紫外
范华东
RAN Qing-xue;ZHONG Zi-wai;FAN Hua-dong(Department of Internal Medicine,Changxing Hospital of Zhejiang Medical and Health Group,Huzhou 313117,China)
出处
《工业卫生与职业病》
CAS
2021年第5期404-407,共4页
Industrial Health and Occupational Diseases
基金
小容量肺灌洗治疗对煤尘肺合并中重度慢性阻塞性肺疾病患者的疗效分析(湖州市科技计划项目:2017GY57)。
关键词
纤维支镜下肺灌洗术
煤工尘肺
慢性阻塞性肺病
炎性因子
Bronchoscopy lung lavage
Coal worker’s pneumoconiosis
Chronic obstructive pulmonary disease
Inflammatory factor
