Significance of monitoring blood gas indexes and serum immune inflammatory factors before and after phentolamine assisted non-invasive positive pressure ventilation in patients with chronic obstructive pulmonary disease complicated with heart failure

LI Juan; WU Lin; ZHANG Hong-xia

doi:10.3969/j.issn.1672-8157.2023.06.003

Abstract：Objective:To study the clinical effect of phentolamine assisted non-invasive positive pressure ventilation(NIPPV)in the treatment of chronic obstructive pulmonary disease(COPD)complicated with heart failure(HF)and the significance of monitoring blood gas indexes and serum immune inflammatory factors before and after treatment.Methods:The clinical data of 98 patients with COPD complicated with HF treated in our hospital were prospectively selected.All patients met the inclusion and exclusion criteria.According to the simple random number table method,all patients were divided into two groups,with 49 in each.The patients in the control group received NIPPV treatment and those in the observation group with phentolamine on the basis of NIPPV treatment.The blood gas indexes of the two groups before and after treatment were compared.At the same time,according to the pulmonary function classification of COPD patients with HF,the changes of serological indexes under different conditions before and after treatment were compared.Results:There was no significant difference in the levels of IL-17A,CD3+,CD4+and PCT between the two groups before treatment(P>0.05).The levels of IL-17A and PCT in grade Ⅲof pulmonary function in the observation group were higher than those in grade Ⅰ(t=4.595,7.734,all P=0.001).The levels of CD3+and CD4+in lung function grade Ⅲ of the observation group were lower than those in grade Ⅰ(t=4.303,5.596,all P=0.001).After 7 days of treatment,the levels of IL-17 A in lung functionⅢ,Ⅱ and Ⅰ in the observation group were(44.63±5.21)ng·L-1,(39.25±6.14)ng·L-1 and(33.44±4.85)ng·L-1,respectively,which were lower than those in the control(47.52±5.96)ng·L-1,(42.52±6.22)ng·L-1 and(37.52±6.20)ng·L-1(t=5.480,2.073,2.271,P=0.001,0.046,0.029).The PCT levels of lung function grade Ⅲ,Ⅱ and Ⅰ in the observation group were(10.15±2.74)µg·L-1,(8.11±1.49)µg·L-1 and(4.68±1.41)µg·L-1,respectively,which were lower than those in the control(12.47±2.17)µg·L-1,(10.11±1.39)µg·L-1 and(6.55±1.74)µg·L-1(t=2.316,2.507,3.656,P=0.030,0.017,0.001).The CD3+levels of lung function grade Ⅲ,Ⅱ andⅠ in the observation group were(51.63±4.60)%,(59.63±4.33)%and(63.52±4.66)%,respectively,which were higher than those in the control(47.85±4.20)%,(56.52±4.52)%and(60.25±4.85)%(t=2.104,2.108,2.119,P=0.047,0.042,0.041).The CD4+levels of lung function gradeⅢ,Ⅱ and Ⅰ in the observation group were(29.66±3.89)%,(33.20±4.56)%and(38.98±4.66)%,respectively,which were higher than those in the control(24.86±4.27)%,(28.52±4.24)%and(34.52±4.58)%(t=2.061,2.507,2.970,P=0.034,0.017,0.005).The levels of IL-17 A and PCT in grade Ⅲ in the observation group were higher than those in grade Ⅱ and grade Ⅰ,and the differences were statistically significant(tIL-17A=2.712,5.641,PIL-17A=0.009,0.001;tPCT=2.990,8.017,PPCT=0.004,0.001).In the control group,the levels of CD3+and CD4+in grade Ⅲ were lower than those in grade Ⅱ and grade I(tCD3+=2.743,9.631,PCD3+=0.008,0.001;tCD4+=2.194,5.775,PCD4+=0.033,0.001).Conclusion:The treatment with phentolamine combined with NIPPV can significantly promote the improvement of serological indicators in patients with COPD and HF,which is conducive to the recovery of respiratory function and body.