不同容量肺灌洗术对合并COPD的尘肺病患者血清炎性因子和肺功能的影响

目的 比较大容量肺灌洗术与小容量肺灌洗术治疗对尘肺病合并慢性阻塞性肺疾病(COPD)患者血清炎性因子及肺功能的改善效果.方法 回顾性选取2017年8月至2019年7月首都医科大学附属北京世纪坛医院收治的90例尘肺合并COPD患者,根据不同容量肺灌洗治疗方案分为2组,每组各45例,对照组采用小容量肺灌洗术治疗,观察组采用...

Effects of different volume pulmonary lavage on serum inflammatory factors and pulmonary function in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease

Objective To compare the effect of large volume lung lavage and small volume lung lavage on the improvement of serum inflammatory factors and lung function in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD). Methods From August 2017 to July 2019,90 patients with pneumoconiosis and COPD admitted to Beijing Shijitan Hospital,Capital Medical University,were retrospectively selected,and they were divided into two groups according to different volume of lung lavage treatment plan,each 45 cases,the control group was treated with small-volume lung lavage,the observation group was treated with large-volume lung lavage. Serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor α(TNF-α),transforming growth factor β1(TGF-β1) ],lung function[forced expiratory volume in the first second(FEV1),ratio of forced expiratory volume in the first second/force vital capacity(FEV1/FVC),peak expiratory flow(PEF) ] before treatment and 30 days after treatment,changes in exercise tolerance and quality of life at 6 months follow-up were compared between the two groups. The occurrence of adverse reactions in the 2 groups of patients was recorded. Results Before treatment,serum IL-6,TNF-α,TGF-β1 levels,FEV1,FEV1/FVC,PEF,6-min walking distance(6 MWD),and St. George’s Respiratory Questionnaire(SGRQ)scores were compared between the two groups,and there was no statistical difference significance(P > 0. 05). Thirty days after treatment,The levels of serum IL-6,TNF-α,TGF-1 in the observation group were(0. 35 ± 0. 08) μg/m L,(150. 35 ± 25. 63) ng/L,(41. 25 ± 5. 32) ng/L,respectively,which were significantly lower than those in the control group [(0. 43 ± 0. 09) g/m L,(182. 76 ± 24. 17) ng/L,(50. 37 ± 5. 17)ng/L],the differences were statistically significant(P < 0. 05). Thirty days after treatment,FEV1,FEV1/FVC and PEF in the observation group were(1. 72 ± 0. 13) L,(69. 59 ± 5. 23) %,(371. 59 ± 10. 58) L/min,respectively,which were significantly higher than those in the control group[(1. 46 ± 0. 12) L,(61. 03 ± 5. 17) %,(347. 02 ± 9. 27) L/min],the differences were statistically significant(P < 0. 05). After follow-up for 6 months,the SGRQ score in the observation group was(41. 39 ± 3. 02) points,which was significantly lower than that in the control group[(49. 27 ± 3. 08) points],and the 6 MWD was(381. 75 ± 18. 31) m,which was significantly higher than that in the control group[(307. 51 ± 17. 59) m],the differences were significant(P < 0. 05). The incidence of adverse reactions between the two groups was compared(35. 6% vs. 31. 1%),the difference was not statistically significant(P > 0. 05). Conclusion Compared with small-volume pulmonary lavage,high-volume pulmonary lavage in the treatment of pneumoconiosis with COPD can further inhibit the expression of serum inflammatory factors,contribute to the enhancement of pulmonary ventilation function,and improve exercise tolerance and quality of life,and its therapeutic safety is comparable to small-volume pulmonary lavage.