纤维支气管镜肺泡灌洗对老年重症肺炎患者肺功能、炎症反应及应激状态的影响(1)
【摘要】 目的：觀察纤维支气管镜肺泡灌洗对老年重症肺炎患者呼吸功能、炎症反应及应激状态的影响。方法：70例老年重症肺炎患者根据治疗方案不同分为对照组和观察组，各35例。对照组予以常规措施治疗，观察组在对照组基础上予以纤维支气管镜肺泡灌洗治疗。采用肺功能仪检测两组患者治疗前后用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC%的变化，采用酶联免疫吸附法检测两组患者治疗前后超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、D-二聚体(D-D)的变化，采用放射免疫法检测皮质醇(Cor)、血管紧张素Ⅰ(Ang-Ⅰ)、血管紧张素Ⅱ(Ang-Ⅱ)的变化。结果：两组患者治疗后肺功能相关指标FVC、FEV1、FEV1/FVC%均较治疗前明显升高，且观察组患者肺功能相关指标升高均较对照组更为明显，差异均有统计学意义(P<0.05)。两组患者治疗后炎症反应相关指标PCT、hs-CRP、D-D均较治疗前均明显降低，且观察组患者炎症反应相关指标降低均较对照组更为明显，差异均有统计学意义(P<0.05)。两组患者治疗后应激状态相关指标Cor、Ang-Ⅰ、Ang-Ⅱ较治疗前均明显降低，且观察组患者应激状态相关指标降低均较对照组更为明显，差异均有统计学意义(P<0.05)。结论：纤维支气管镜肺泡灌洗可明显改善老年重症肺炎患者呼吸功能、炎症反应及应激状态，可在临床推广应用。
【关键词】 纤维支气管镜肺泡灌洗 重症肺炎 肺功能 炎症反应 应激状态
Effect of Bronchoscopic Alveolar Lavage on Pulmonary Function， Inflammatory Response and Stress State in Elderly Patients with Severe Pneumonia/ZENG Jing， WEI Dong， CHEN Yongmei， XU Yasheng. //Medical Innovation of China， 2020， 17(10)： 0-026
[Abstract] Objective： To observe the effect of bronchoscopic alveolar lavage on respiratory function， inflammatory response and stress state in elderly patients with severe pneumonia. Method： A total of 70 elderly patients with severe pneumonia were divided into the control group and the observation group， 35 cases in each group， according to different treatment schemes. The control group was treated with routine measures， the observation group was treated with bronchoscopic alveolar lavage on the basis of the control group. The changes of forced vital capacity (FVC)， forced expiratory volume in one second (FEV1) and FEV1/FVC% of two groups before and after treatment were detected by pulmonary function instrument. The changes of hs-CRP， PCT， D-D of two groups before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). The Cortisol， Ang-Ⅰ， Ang-Ⅱ of two groups before and after treatment were detected by immunoassay. Result： FVC， FEV1 and FEV1/FVC%
were significantly higher in the two groups after treatment than those before treatment， and the lung function related indicators in the observation group were significantly higher than those in the control group， with statistically significant differences (P<0.05). After treatment， PCT， hs-CRP and D-D related indicators of inflammatory response in the two groups were significantly lower than those before treatment， and the related indicators of inflammatory response in the observation group were significantly lower than those in the control group， with statistically significant differences (P<0.05). Cor， Ang-Ⅰ and Ang-Ⅱ were significantly lower in the two groups than those before treatment， and the reduction of Cor， Ang-Ⅰ and Ang-Ⅱ in the observation group were more significant than those in the control group， with statistically significant differences (P<0.05). Conclusion： Alveolar lavage under fiberoptic bronchoscope can significantly improve respiratory function， inflammatory response and stress state of elderly patients with severe pneumonia， which can be popularized and applied in clinical practice., 百拇医药(曾静 魏东 陈咏梅 许雅胜)
【关键词】 纤维支气管镜肺泡灌洗 重症肺炎 肺功能 炎症反应 应激状态
Effect of Bronchoscopic Alveolar Lavage on Pulmonary Function， Inflammatory Response and Stress State in Elderly Patients with Severe Pneumonia/ZENG Jing， WEI Dong， CHEN Yongmei， XU Yasheng. //Medical Innovation of China， 2020， 17(10)： 0-026
[Abstract] Objective： To observe the effect of bronchoscopic alveolar lavage on respiratory function， inflammatory response and stress state in elderly patients with severe pneumonia. Method： A total of 70 elderly patients with severe pneumonia were divided into the control group and the observation group， 35 cases in each group， according to different treatment schemes. The control group was treated with routine measures， the observation group was treated with bronchoscopic alveolar lavage on the basis of the control group. The changes of forced vital capacity (FVC)， forced expiratory volume in one second (FEV1) and FEV1/FVC% of two groups before and after treatment were detected by pulmonary function instrument. The changes of hs-CRP， PCT， D-D of two groups before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). The Cortisol， Ang-Ⅰ， Ang-Ⅱ of two groups before and after treatment were detected by immunoassay. Result： FVC， FEV1 and FEV1/FVC%
were significantly higher in the two groups after treatment than those before treatment， and the lung function related indicators in the observation group were significantly higher than those in the control group， with statistically significant differences (P<0.05). After treatment， PCT， hs-CRP and D-D related indicators of inflammatory response in the two groups were significantly lower than those before treatment， and the related indicators of inflammatory response in the observation group were significantly lower than those in the control group， with statistically significant differences (P<0.05). Cor， Ang-Ⅰ and Ang-Ⅱ were significantly lower in the two groups than those before treatment， and the reduction of Cor， Ang-Ⅰ and Ang-Ⅱ in the observation group were more significant than those in the control group， with statistically significant differences (P<0.05). Conclusion： Alveolar lavage under fiberoptic bronchoscope can significantly improve respiratory function， inflammatory response and stress state of elderly patients with severe pneumonia， which can be popularized and applied in clinical practice., 百拇医药(曾静 魏东 陈咏梅 许雅胜)
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