目的:探讨经鼻高流量氧气联合布地奈德福莫特罗治疗慢阻肺急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者效果及其对环氧化酶-2(Cyclooxygenase-2,COX-2)与α2-巨球蛋白(Alpha2-macroglobulin,α2-MG)水平影响.方法:选取2021年 3月至2023年 3月本院治疗的AECOPD病人84 例,随机分为对照组和研究组,每组各 42 例.对照组采用雾化吸入布地奈德福莫特罗粉治疗;研究组在对照组基础上联合采用经鼻高流量氧气疗法.分析比较两组治疗4 w的临床疗效;采用肺功能测试仪测定治疗前及治疗后4 w肺功能相关指标;采用酶联免疫吸附法检测治疗前及治疗后4 w血清COX-2 及α2-MG水平.结果:研究组治疗后的总有效率显著高于对照组(P＜0.05).治疗后,两组的第1 s用力的具体呼气量情况(Forced expiratory volume in one second,FEV1)、FEV1与预计值之间的比值百分数(FEV1%)、FEV1与用力肺活量(forced vital capacity,FVC)之间的具体比值(FEV1/FVC)均比治疗前显著提升,且研究组的FEV1%、FEV1和FEV1/FVC均比对照组显著提高(P＜0.05).治疗后,两组血清的COX-2 水平均较治疗前显著降低,α2-MG水平均较治疗前显著升高,且观察组的变化幅度显著大于对照组(P＜0.05).结论:AECOPD病人在实施雾化吸入布地奈德福莫特罗结合经鼻高流量氧气可改善其肺功能,提高治疗效果,并降低COX-2、α2-MG水平.
Effect of nasal high-flow oxygen combined with budesonide and formoterol on the levels of cyclooxygenase-2 and α2-macroglobulin in patients with acute COPD attacks
Objective:To investigate the treatment of Acute exacerbation of chronic obstructive pulmonary disease by nasal high flow oxygen combined with budesonide formoterol.Efficacy of AECOPD in patients and its influence on the levels of Cyclooxygenase-2(COX-2)and Alpha2-macroglobulin(alpha2-mg).Methods:A total of 84 AECOPD patients treated in our hospital from March 2021 to March 2023 were randomly divided into control group and study group,with 42 cases in each group.The control group was treated with atomized budesonide formoterol powder;The study group was combined with nasal high-flow oxygen therapy on the basis of control group.The clinical efficacy of the two groups for 4 weeks was analyzed and compared.Pulmonary function tester was used to measure the relevant indexes of pulmonary function before and 4 weeks after treatment.Serum COX-2 and α2-MG levels were detected by enzyme-linked immunosorbent assay(ELISA)before and 4 weeks after treatment.Results:The total effective rate of the study group was significantly higher than that of the control group(P<0.05).After treatment,Forced expiratory volume in one second(FEV1),percentage ratio between FEV1 and predicted value(FEV1%),and specific ratio between FEV1 and forced vital capacity(FVC)(FEV1/FVC)were significantly higher than before treatment.Fev1%,FEV1 and FEV1/FVC in the study group were significantly higher than those in the control group(P<0.05).After treatment,the serum COX-2 level and α2-MG level in both groups were significantly decreased compared with before treatment,and the change range of observation group was significantly greater than that of control group(P<0.05).Conclusion:Nebulizing budesonide and formoterol combined with nasal high-flow oxygen can improve lung function,improve therapeutic effect,and reduce COX-2 and α2-MG levels in AECOPD patients.
nasal high flow oxygenBudesonide formoterolCopd acute exacerbation stageCycloxygenase-2α2-macroglobulin
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