乙酰唑胺对慢性阻塞性肺疾病无创通气酸碱平衡的影响

目的探讨乙酰唑胺对慢性阻塞性肺疾病(COPD)无创通气患者酸碱平衡的影响。方法选择2010-2014年急性加重期COPD患者70例,分为乙酰唑胺治疗组(研究组,38例)和非乙酰唑胺治疗组(对照组,32例),测定患者服用乙酰唑胺0、24、48 h后的PaCO_2、HCO_3~-,以及血清、尿液的pH值。结果研究组患者治疗后24、48 h的PaCO_2、HCO_3~-、血清pH值均降低(P<0.05),尿pH值升高(P<0.05),但治疗24 h与48 h比较差异无统计学意义(P>0.05),对照组仅在治疗48 h时HCO_3~-降低,尿pH升高(P<0.05)。研究组无创通气治疗时间较对照组缩短[(5.53±1.72)d vs.(18.81±4.08)d,P<0.001],但两组住院时间比较差异无统计学意义(t=0.418,P=0.877)。结论乙酰唑胺能有效改善COPD患者的PaCO_2、HCO_3~-及血清和尿液的pH值,连续2d服用可缩短无创通气治疗时间。

Effects of acetazolamide on acid-base balance in patients with chronic obstructive pulmonary disease undergiong noninvasive ventilation

Objective To discuss the effect of acetazolamide on acid-base balance in patients with chronic ob-structive pulmonary disease undergiong noninvasive ventilation. Methods Totally 70 patients with acute exacerbation of chronic obstructive pulmonary disease ( COPD) from 2010 to 2014 were divided into acetazolamide treatment group (experimental group,n=38) and non-acetazolamide treatment group (control group,n=32). The PaCO2,HCO3- and the pH value of serum and urine at 0,24 and 48 h after oral administration of acetazolamide were detected. Results PaCO2 ,HCO3- and serum pH value in patients of experiment group at 24 h and 48 h after treatment decreased signifi-cantly (P<0. 05),and urinary pH value increased,but there was no significant difference between the indexes at 24 h and 48 h after treatment (P>0. 05);the HCO3- in control group significantly decreased,while the urinary pH value in-creased at 48 h after treatment. The ventilation length of experiment group was significantly shorter than that of control group[(5. 53 ± 1. 72) d vs. (18. 81 ± 4. 08) d,t=17. 197,P<0. 001],but there was no significant difference in the hospitalization length between the two groups (t=0. 418,P=0. 877). Conclusion Acetazolamide can effectively im-prove the PaCO2 ,HCO3- and the pH value of serum and urine in the patients with COPD,and oral administration of ac-etazolamide for two consecutive days can significantly shorten the noninvasive ventilation time.