目的 探讨慢阻肺急性加重合并呼吸衰竭患者采用双水平无创正压通气联合布地格福吸入气雾剂治疗的临床效果。方法 以随机数字表法将2021年9月至2023年9月郑州大学第一附属医院收治86例慢阻肺急性加重合并呼吸衰竭患者分为对照组(43例，双水平无创正压通气+甲泼尼龙治疗)和观察组(43例，双水平无创正压通气+布地格福吸入气雾剂治疗)，均治疗5 d。比较两组患者疗效、动脉血气指标、血清低氧诱导因子-1α和4-羟基壬烯醛水平、不良反应发生情况。结果 对照组总有效率、动脉血氧分压(partial pressure of oxygen，PO2)、pH水平低于观察组，动脉血氧二氧化碳分压(partial pressure of carbon dioxide，pCO2)、血清低氧诱导因子-1α、4-羟基壬烯醛水平高于观察组，差异有统计学意义(P＜0。05);治疗期间，对照组不良反应总发生率高于观察组，差异有统计学意义(P＜0。05)。结论 慢阻肺急性加重合并呼吸衰竭患者采用布地格福吸入气雾剂联合双水平无创正压通气治疗的临床效果显著，可改善患者血气指标，并降低患者低氧诱导因子-1α、4-羟基壬烯醛水平和不良反应发生率。
Effect of budesonide inhalation aerosol combined with bi-level non-invasivepositive pressure ventilation in treatment of acute exacerbation of chronic obstructive pulmonary disease with respiratory failure
Objective To investigate the clinical effect of bi-level non-invasive positive pressure ventilation combined with budesonide inhalation aerosol in patients with acute exacerbation of chronic obstructive pulmonary disease complicat-ed with respiratory failure.Methods Totally 86 patients with acute exacerbation of chronic obstructive pulmonary dis-ease complicated with respiratory failure admitted to the First Affiliated Hospital of Zhengzhou University from September 2021 to September 2023 were divided into control group(43 cases,bi-level non-invasive positive pressure ventilation and methylprednisolone treatment)and observation group(43 cases,bi-level non-invasive positive pressure ventila-tion and budesonide inhalation aerosol treatment)by random number table method.Both groups were treated for 5 days.The efficacy,arterial blood gas index,serum hypoxia-inducible factor-1α and 4-hydroxynonenal levels,and adverse reactions were compared between the two groups.Results The total effective rate,PO2 and pH levels in the control group were lower than those in the observation group,and the levels of pCO2,serum hypoxia inducible factor-1 α and 4-hydroxynonenal were higher than those in the observation group(P＜0.05).During the treatment,compared with ob-servation group,the total incidence of adverse reactions in the control group was higher(P＜0.05).Conclusion The clinical effect of budesonide inhalation aerosol combined with bi-level non-invasive positive pressure ventilation in pa-tients with acute exacerbation of chronic obstructive pulmonary disease complicated with respiratory failure is significant.It can improve the blood gas index of patients,and reduce the levels of hypoxia-inducible factor-1α and 4-hydroxynonenal and the incidence of adverse reactions.
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