The efficacy of external diaphragm pacing combined with recombinant human growth hormone in the treatment of severe chronic obstructive pulmonary disease
10.3760/cma.j.cn115455-20231221-00596
- VernacularTitle:体外膈肌起搏联合重组人生长激素治疗重度慢性阻塞性肺疾病的效果观察
- Author:
Yongji ZHU
1
;
Yuesong SHEN
1
;
Huiqing ZHU
1
Author Information
1. 仙居县人民医院（浙江省人民医院浙东南院区）/杭州医学院附属仙居医院重症医学科，台州 317300
- Publication Type:Journal Article
- Keywords:
Pulmonary disease, chronic obstructive;
External diaphragm pacing;
Recombinant human growth hormone;
Comparative study
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(2):159-163
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the efficacy of external diaphragm pacing (EDP) combined with recombinant human growth hormone (rhGH) in the treatment of severe chronic obstructive pulmonary disease (CDOP).Methods:By the prospective study method, 80 patients with severe COPD were admitted to the Xianju People′s Hospital(Zhejiang Southeast Campus of Zhejiang Provincial People′s Hospital)/Xianju Hospital Affiliated to Hangzhou Medical College from April 2021 to April 2023 were divided into the combined group and the conventional group by the random number table method, with 40 cases in each group. All of them received anti-infection, nutritional support, and other conventional treatment. In addition, the combined group was given EDP+rhGH treatment, and they were intervened for 20 d. The diaphragm function, nutrition, pulmonary function, and serum levels of interleukin (IL-6), IL-23, type Ⅱ alveolar cell surface antigen (KL-6) changes before and after treatment and prognosis were compared between the two groups.Results:After treatment, the diaphragm function index diaphragm maximum expiratory pressure (MIP), diaphragm thickness (DTei), and diaphragm mobility (DE) in the combined group were higher than those in the conventional group: (45.36 ± 7.04) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (42.28 ± 6.43) cmH 2O, (0.32 ± 0.12) cm vs. (0.27 ± 0.06) cm, (3.40 ± 1.02) cm vs. (1.85 ± 0.64) cm, there were statistical differences ( P<0.05). After treatment, the nutritional status indexes of serum albumin (ALB), transferrin (Tf), and total protein (TP) in the combined group were higher than those in the conventional group: (34.62 ± 5.13) g/L vs. (31.75 ± 4.93) g/L, (2.21 ± 0.46) g/L vs. (2.00 ± 0.42) g/L, (63.80 ± 8.25) g/L vs. (60.24 ± 6.97) g/L, there were statistical differences ( P<0.05). After treatment, the percentage of forced expiratory volume in the first second (FEV 1) to the expected value (FEV 1%) and the ratio of FEV 1 to forced vital capacity (FEV 1/FVC) in the combined group were higher than those in the conventional group: (60.17 ± 6.30)% vs. (57.25 ± 6.24)%, (61.30 ± 7.04)% vs. (57.12 ± 7.25)%, there were statistical differences ( P<0.05). After treatment, the levels of IL-6, IL-23, and KL-6 in the combined group were lower than those in the conventional group: (23.13 ± 4.26) ng/L vs. (26.60 ± 4.75) ng/L, (20.84 ± 6.16) μg/L vs. (25.00 ± 5.89) μg/L, (375.10 ± 45.18) kU/L vs. (400.25 ± 46.27) kU/L, there were statistical differences ( P<0.05). The mechanical ventilation time and intensive care unit stay time in the combined group were shorter than those in the conventional group: (150.46 ± 10.24) h vs. (189.67 ± 15.43) h, (7.00 ± 2.03) d vs. (9.84 ± 2.72) d, there were statistical differences ( P<0.05). The rate of extubation within 1 week in the combined group was higher than that in the conventional group, and the 28-day mortality was lower than that in the conventional group: 90.00%(36/40) vs. 72.50%(29/40), 5.00%(2/40) vs. 22.50%(9/40), there were statistical differences ( χ2 = 4.02, 5.16, P<0.05). Conclusions:In the patients with severe COPD, EDP combined with rhGH can significantly improve the diaphragm function, nutritional status, and lung function, decrease serum IL-6, IL-23, and KL-6 levels, shorten the mechanical ventilation time, and reduce the 28-day mortality.
