摘要
目的探讨早期肺康复干预治疗老年2型糖尿病(T2DM)合并卒中相关性肺炎(SAP)患者的疗效。方法前瞻性选取2021年3月~2022年10月石家庄市第二医院收治的老年T2DM合并SAP患者110例,随机数表法分为观察组和对照组,各55例。对照组在常规治疗基础上予利拉鲁肽联合哌拉西林钠他唑巴坦钠治疗,观察组在对照组基础上予早期肺康复干预治疗,两组均治疗2周。比较两组治疗前后的肺功能指标[第1秒用力呼气量(FEV1)、最大呼气量(FVC)、第1秒用力呼气量占用最大呼气量比值(FEV1∕FVC)]、临床肺部感染(CPIS)评分及血清炎症因子水平[血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]。比较两组患者的疗效及不良反应。结果观察组患者临床总有效率(92.73%)高于对照组(78.18%),差异有统计学意义(χ^(2)=4.681,P<0.05)。治疗后,观察组患者FEV1、FVC及FEV1∕FVC水平高于对照组[(3.78±0.96)L vs.(3.24±0.92)L、(5.27±1.42)L vs.(4.21±1.46)L、(78.29±12.48)vs.(71.36±11.45)],差异有统计学意义(t=3.012、3.860、3.035,P<0.05);观察组血清PCT、hs-CRP、TNF-α水平均降低于对照组[(0.92±0.25)μg∕L vs.(1.13±0.37)μg∕L、(12.86±3.14)mg∕L vs.(15.41±3.58)mg∕L、(2.84±0.78)μg∕L vs.(3.42±0.93)μg∕L],差异有统计学意义(t=3.488、3.971、3.544,P<0.05)。观察组患者不良反应总发生率与对照组比较(9.09%vs.12.73%),差异无统计学意义(χ^(2)=0.374,P>0.05)。结论早期肺康复干预治疗老年T2DM合并SAP患者时的治疗效果较好,促进肺功能的康复,降低血清炎症因子水平,且安全性较好,可为临床治疗及干预措施提供新思路。
Objective To explore the efficacy of early pulmonary rehabilitation intervention in treating elder patients with T2DM combined with SAP.Methods 110 cases of elderly patients with T2DM combined with SAP admitted to the Second Hospital of Shijiazhuang City from March 2021 to October 2022 were selected and divided into observation group and control group,with each group 55 cases.Control group received routine treatment with liraglutide and piperacillin sodium tazobactam sodium,and observation group received early pulmonary rehabilitation intervention on this basis.Both groups were treated for 2 weeks.Compared the lung function indexes(FEV1,FVC,FEV1∕FVC),CPIS score,serum inflammatory factor levels[serum PCT,hs-CRP,TNF-α],efficacy and adverse reactions.Results The total clinical effective rate of observation group(92.73%)was higher than that of control group(78.18%)(χ^(2)=4.681,P<0.05).After,FEV1,FVC and FEV1∕FVC levels in observation group were higher than those in control group[(3.78±0.96)L vs.(3.24±0.92)L,(5.27±1.42)L vs.(4.21±1.46)L,(78.29±12.48)vs.(71.36±11.45)],with statistically significant differences(t=3.012,3.860,3.035,P<0.05).Serum PCT,hs-CRP,and TNF-αlevels were lower in observation group than in control group[(0.92±0.25)μg∕L vs.(1.13±0.37)μg∕L,(12.86±3.14)mg∕L vs.(15.41±3.58)mg∕L,(2.84±0.78)μg∕L vs.(3.42±0.93)μg∕L],and the differences were statistically significant(t=3.488,3.971,3.544,P<0.05).The total incidence of adverse reactions in patients in the observation group compared with the control group(9.09%vs.12.73%),the difference was not statistically significant(χ^(2)=0.374,P>0.05).Conclusion Early pulmonary rehabilitation intervention has shown good therapeutic effects in elderly T2DM patients with SAP,promoting the recovery of lung function,reducing serum inflammatory factor levels,and owning good safety.It can provide new ideas for clinical treatment and intervention measures.
作者
于凯娜
高耐芬
范素芳
邸沂遥
车琮璐
许圣慧
Yu Kaina;Gao Naifen;Fan Sufang(Department of Respiratory,Shijiazhuang Second Hospital,Shijiazhuang 050000,China)
出处
《中华保健医学杂志》
2024年第6期765-768,共4页
Chinese Journal of Health Care and Medicine
基金
河北省医学科学研究课题计划项目(20231631)。
关键词
早期肺康复干预
2型糖尿病
卒中相关性肺炎
血清炎症因子
Early pulmonary rehabilitation intervention
Type 2 diabetes mellitus
Stroke-associated pneumonia
Serum
