依达拉奉联合适应性机械通气对COPD伴呼吸衰竭血清CC16、PARC/CCL18和KL-6水平的影响

目的 观察依达拉奉联合适应性机械通气对慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）伴Ⅱ型呼吸衰竭的疗效及其对血清克拉细胞分泌蛋白（clara cell secretory protein，CC16），肺部活化调节趋化因子（pulmonary activation-regulating chemokine，PARC/CCL18）和Ⅱ型肺泡表面抗原6（krebs von den Lundgen-6，KL-6）的影响。方法 选择COPD合并Ⅱ型呼吸衰竭患者112例，根据随机数字法将患者分为观察组和对照组，每组56例，对照组予以适应性机械通气治疗，观察组在对照组的基础上予以依达拉奉治疗。观察两组的疗效，治疗前后COPD评估测试（COPD assessment test，CAT）评分、呼吸困难评分、生活质量、用力肺活量（forced vital capacity，FVC）、呼气量峰流速（peak expiratory flow，PEF）、第1秒用力呼气量（forced expiratory volume second，FEV1）、最大自主通气量（maximum voluntary ventilation，MVV）、氧分压（partial pressure of oxygen，PaO2）、二氧化碳分压（partial pressure of carbon dioxide，PaCO2）、血氧饱和度（oxygen saturation，SaO2）、pH值、CC16、PARC/CCL18和KL-6水平的变化。结果 观察组的总有效率为94.64%，对照组为80.36%，差异有统计学意义（Z=6206，P＜0.01）。两组治疗后生活质量、FVC、PEF、FEV1、MVV、PaO2、SaO2、 pH值和CC16水平较治疗前明显增加（P＜0.01），而CAT评分、呼吸困难评分、PaCO2、PARC/CCL18和KL-6较治疗前明显降低（P＜0.01），而观察组的升高或者降低水平较对照组更加明显（P＜0.01）。结论 依达拉奉联合适应性机械通气对COPD伴呼吸衰竭疗效显著，具有改善呼吸功能和生活质量，纠正血气，有助于肺泡细胞的修复。

Effects of edaravone combined with adaptive mechanical ventilation on serum levels of CC16,PARC/CCL18 and KL-6 in COPD patients with respiratory failure

Objective To observe the efficacy of edaravone combined with adaptive mechanical ventilation on chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure and their impact on serum clara cell secretory protein(CC16) and pulmonary activation-regulating chemokine(PARC/CCL18) and krebs von den lundgen-6(KL-6) .Methods A total of 112 COPD patients with type Ⅱ respiratory failure were divided into observation group and control group according to random number method, each group had 56 cases. The control group were treated with adaptive mechanical ventilation, and the observation group was treated with edaravone on the basis of the control group. The efficacy, COPD assessment test(CAT) score, dyspnea, quality of life were observed in two groups after treatment,the forced vital capacity(FVC), peak expiratory flow(PEF), forced expiratory volume second(FEV1), maximum voluntary ventilation(MVV), partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), oxygen saturation(SaO2), pH, CC16, PARC/CCL18 and KL-6 were observed in two groups before and after treatment.Results The total effective rate was 94.64% in the observation group, and 80.36% in the control group, the difference was statistically significant by rank sum test(Z=6206，P＜0.01). After treatment the quality of life, FVC, PEF, FEV1, MVV, PaO2, SaO2, pH and CC16were significantly increased compared with before treatment(P＜0.01), while the CAT score, dyspnea score, PaCO2, PARC/CCL18 and KL-6 was significantly lower than before treatment(P＜0.01), while the increasing or decreasing levels in the observation group were more obvious than those in the control group(P＜0.01).Conclusion Edaravone combined with adaptive mechanical ventilation has significant effects on COPD with respiratory failure, improving respiratory function and quality of life, correcting blood gas, and contributing to the repair of alveolar cells.