沙美特罗替卡松(舒利迭)联合双水平气道正压通气对中重度COPD合并Ⅱ型呼吸衰竭患者生活质量的影响

目的：观察予以沙美特罗替卡松（舒利迭）联合双水平气道正压通气长期治疗Ⅲ～Ⅳ级慢性阻塞性肺疾病（COPD）合并Ⅱ型呼吸衰竭患者,对患者的肺通气功能、焦虑抑郁、生活质量、COPD急性加重的次数的影响。方法：48例病人按双水平气道正压通气是否联合连续吸入舒利迭（50μg/500μg）,随机分为两组,观察治疗前、治疗7d后及随访3个月、6个月后患者的动脉血气、肺通气功能、6min步行距离（6MWD）、SGRQ评分的变化及SAS评分的变化、COPD急性加重的次数。结果：治疗后两组动脉血气（PaO2、PaCO2）、肺通气功能指标（FVC、FEV1）、6min步行距离、SGRQ评分、SAS评分改善较治疗前明显改善（P〈0.05）,以治疗组改善明显;治疗6月后治疗组COPD急性加重的次数少于对照组。结论：沙美特罗替卡松（舒利迭）联合双水平气道正压通气长期治疗Ⅲ～Ⅳ级COPD患者能改善和延缓肺功能下降速度,能显著改善病人的SGRQ评分、SAS评分,改善病情的严重度,减少COPD急性加重的次数。

Influence of the curative effect of salmeterol/fluticasone and bi-level positive airway pressure on severe chronic obstructive pulmonary disease with respiratory failure

AIM： To observe the curative effect of inhaling Salmeterol（50 microg）/ fluticasion（500 microg） and bi-level positive airway pressure for severe chronic obstructive pulmonary disease（COPD） with respiratory failure cases on lung function,anxiety and depression,quality of life and the times of acute exacerbation of COPD.METHODS： 48 severe COPD with respiratory failure cases were randomly divided into two groups.The therapy group received inhaling.Salmeterol/fluticasion and bi-level positive airway pressure including routine treatment.At the same time,the comparative group were given bi-level positive airway pressure including routine treatment.The arterial blood gas,lung function,six minutes walking distance（6MWD）,the scores of SGRQ and SAS and the times of acute exacerbation of COPD were observed before the treatment,and 7 days,3 months,6 months after the treatment.RESULTS：The arterial blood gas,lung function,six minutes walking distance（6MWD）,the scores of SGRQ and SAS and reduce the frequence of exacerbations of COPD of the treatment group and the end of 6 months.The significant differences were seen between the treatment group and the comparative group.The therapy group had better curative effect than the comparative group.CONCLUSION： The treatment of severe COPD with Respiratory failure cases inhaling.Salmeterol/fluticasion and bi-level positive airway pressure were effective.