目的 探讨布地奈德福莫特罗联合气道正压通气吸入剂治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome，OSAHS)合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease，COPD)的临床效果。方法 选取2022年1月—2023年12月如皋市人民医院呼吸内科收治的60例OSAHS合并COPD患者，采用随机数字抽样法分为粉雾剂组和正压组，每组30例。正压组采用气道正压通气治疗，此基础上粉雾剂组患者增加布地奈德福莫特罗吸入治疗，观察2组患者睡眠呼吸暂停改善情况，并比较2组肺功能及生活质量改善情况。结果 粉雾剂组治疗后肺活量(vital capacity，VC)和第1秒用力呼气容积(forced expiratory volume in one second，FEV1)分别为(4。12±0。75)L和(3。59±0。75)L，高于正压组的(3。71±0。85)L和(2。78±0。42)L，差异均有统计学意义(P<0。05)。粉雾剂组呼吸频率(respiratory rate，RR)为(14。13±3。29)次/min，低于正压组的(16。11±2。69)次/min，差异有统计学意义(P<0。05)。粉雾剂组最低血氧饱和度水平为(98。02±2。47)％，高于正压组的(94。52±1。93)％，差异有统计学意义(P<0。05)。粉雾剂组治疗后呼吸暂停指数、低通气指数、呼吸暂停低通气指数、与呼吸事件相关微觉醒指数低于正压组，最低血氧饱和度水平高于正压组，差异有统计学意义(P<0。05)。粉雾剂组治疗后生活质量评分高于正压组，差异有统计学意义(P<0。05)。粉雾剂组患者不良反应总发生率为6。67％(2/30)，与正压组的6。67％(2/30)比较，差异无统计学意义(P>0。05)。结论 在气道正压通气基础上，联合布地奈德福莫特罗吸入治疗，可有效提升治疗效果，改善患者睡眠呼吸暂停病情，提升肺功能，对患者生活质量提升显著，且不良反应风险较低，临床应用价值较高。
The Efficacy of Budesonide and Formoterol Inhalation Combined With Positive Airway Pressure Ventilation in the Treatment of Obstructive Sleep Apnea Hypopnea Syndrome With Chronic Obstructive Pulmonary Disease
Objective To investigate the clinical efficacy of budesonide and formoterol combined with positive airway pressure therapy in the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) with chronic obstructive pulmonary disease (COPD).Methods Sixty patients with OSAHS and COPD admitted to department of respiratory,the People's Hospital of Rugao from January 2022 to December 2023 were randomly divided into a powder mist group and a positive pressure group,with 30 patients in each group,using a random number sampling method.The positive pressure group was treated with positive airway pressure ventilation,and on this basis,the powder mist group was treated with budesonide and formoterol inhalation.The improvement of sleep apnea in the two groups of patients was observed,and the improvement of lung function and quality of life was compared between the two groups.Results After treatment,the vital capacity (VC) and forced expiratory volume in one second (FEV1) of the powder mist group were (4.12±0.75) L and (3.59±0.75) L,respectively,which were higher than those of the positive pressure group (3.71±0.85) L and (2.78±0.42) L,and the differences were statistically significant (P<0.05).The respiratory rate (RR) of the powder mist group was (14.13±3.29) times/min,lower than that of the positive pressure group (16.11±2.69) times/min,and differences were statistically significant (P<0.05).The lowest level of blood oxygen saturation in the powder mist group was (98.02±2.47)％,higher than that in the positive pressure group (94.52±1.93)％,and the difference was significant (P<0.05).After treatment,the apnea index,hypopnea index,apnea hypopnea index,and micro arousal index related to respiratory events in the powder mist group were lower than those in the positive pressure group,and the minimum blood oxygen saturation level was higher than that of the positive pressure group,the differences were statistically significant (P<0.05).The quality of life score of the powder mist group after treatment was higher than that of the positive pressure group,the difference was statistically significant ( (P<0.05).The incidence of adverse reactions in the powder mist group was 6.67％ (2/30),which was not statistically significant compared to 6.67％ (2/30) in the positive pressure group (P>0.05).Conclusion On the basis of positive airway pressure ventilation,combined with budesonide and formoterol inhalation therapy,it can effectively improve the treatment effect,improve the patient's sleep apnea condition,enhance lung function,significantly improve the patient's quality of life,and have a low risk of adverse reactions,with high clinical application value.
万方数据
维普
