Efficacy of tiotropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease complicated by type 2 respiratory failure and its effects on inflammatory factors
10.3760/cma.j.cn341190-20240827-01099
- VernacularTitle:噻托溴铵治疗AECOPD并发Ⅱ型呼吸衰竭的疗效观察及对炎症因子的影响
- Author:
Fei REN
1
;
Zhaofang LIU
Author Information
1. 青岛大学附属青岛市第三人民医院呼吸与危重症医学科，青岛 266000
- Publication Type:Journal Article
- Keywords:
Pulmonary disease, chronic obstructive;
Continuous positive airway pressure;
Tiotropium bromide;
C-reactive protein;
Interleukin-6;
Tumor necrosis factor-a
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(7):1006-1012
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of tiotropium bromide combined with bilevel positive airway pressure (BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type 2 respiratory failure and its effects on serum level of inflammatory factors in patients.Methods:A total of 90 patients with AECOPD complicated by type 2 respiratory failure admitted to the Department of Respiratory Medicine, The Affiliated Qingdao Third People's Hospital of Qingdao University from June 2021 to June 2023 were included in this study. This study used a randomized controlled design. The patients included were divided into a control group and an observation group ( n = 45/group) using a random number table method. The control group was given conventional treatment in addition to mechanical ventilation using a BiPAP respirator. Patients in the control group used the spontaneous/timed (S/T) mode, which automatically switched between spontaneous breathing and time-controlled ventilation. The observation group received inhalation treatment with tiotropium bromide in addition to the treatment provided to the control group. The efficacy and serum levels of inflammatory factors (high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6) were compared between the two groups. Results:After treatment, the mMRC (Modified Medical Research Council) Dyspnoea Scale score and chronic obstructive pulmonary disease assessment test score in the observation group were (1.40 ± 0.35) and (12.42 ± 2.57), respectively. These values were significantly lower than those in the control group [(2.62 ± 0.55), (19.05 ± 3.13), t = -4.05, -3.65, both P < 0.05]. After treatment, the acute physiology and chronic health evaluation Ⅱ score in the observation group was (13.85 ± 1.24), which was significantly lower than that in the control group [(18.24 ± 1.58), t = -3.92, P < 0.05]. After treatment, oxygen saturation and partial pressure of oxygen in the observation group were (95.18 ± 5.82) % and (84.37 ± 5.54) mmHg (1 mmHg = 0.133 kPa), respectively. These values were significantly higher than those in the control group [(91.42 ± 5.79) %, (72.41 ± 4.79) mmHg, t = 3.99, 3.96, both P < 0.05]. Partial pressure of carbon dioxide in the observation group was (34.37 ± 1.97) mmHg, which was significantly lower than that in the control group [(41.68 ± 2.19) mmHg, t = -3.72, P < 0.05]. After treatment, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6 levels in the observation group were (13.18 ± 1.43) mg/L, (8.42 ± 1.26) ng/L, and (9.18 ± 1.05) ng/L, respectively. These values were significantly lower than those in the control group [(19.28 ± 2.36) mg/L, (15.76 ± 1.73) ng/L, (19.38 ± 1.61) ng/L, t = -4.22, -5.23, -6.18, all P < 0.05]. The total response rate in the observation group was significantly higher than that in the control group [91.11% (41/45) vs. 73.33% (33/45), χ2 = 5.86, P < 0.05). Conclusions:Inhalation treatment with tiotropium bromide combined with mechanical ventilation using a BiPAP respirator can effectively reduce the severity of dyspnea and alleviate clinical symptoms in patients with AECOPD complicated by type Ⅱ respiratory failure. This combination therapy reduces hypoxia and carbon dioxide retention, diminishes inflammatory response, and enhances overall clinical efficacy.
