[热螺旋、一氧化氮和分子氢在慢性阻塞性肺疾病加重合并低氧血症、高碳酸血症性呼吸衰竭和继发性肺动脉高压患者中综合使用的有效性和安全性]。

IF 0.3 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
L V Shogenova
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引用次数: 0

摘要

目的:探讨热螺旋体(t-He/O2)、一氧化氮(NO)和分子氢(H2)联合应用于慢性阻塞性肺疾病(COPD)加重期合并低氧血症、高碳血症性呼吸衰竭(RF)和继发性肺动脉高压(PAH)患者的疗效和安全性。材料和方法:这项随机、比较、对照、平行研究纳入了COPD证据C和D (GOLD 2021-2023)水平加重的低氧血症、高碳酸血症性呼吸衰竭和继发性PAH患者(n=100,男性52名,女性48名),住院前患有SARS-CoV-2引起的肺炎。将人口统计学、临床和功能参数相似且在标准药物治疗的基础上接受无创通气(NIV)和氧气(O2)治疗的患者分为5组:第一组(n=22):男性12例,女性10例,依次接受t-He/O2、NO和H2治疗;第二组(n=20):男10名,女10名,均接受t-He/O2和NO治疗;第三组(n=20):男性11人,女性9人,均接受t-He/O2和H2治疗;第4组(n=18:男性10人,女性8人,分别给予NO和H2治疗);第五组(对照组)(n=20:男性9人,女性11人)。评估患者的临床状况、肺内气体交换、酸碱平衡、左右排出分数、血流动力学参数和运动耐量的动力学。结果:与单独使用医用气体的患者及对照组相比,复合使用医用气体对患者临床状况、肺内气体交换参数、代谢、血流动力学参数及运动耐量等指标均有积极影响。结论:t-He/O2、NO、H2联合病原学治疗合并低氧血症、高血氧性RF和继发性PAH的COPD加重患者,与单独使用各气体治疗组相比,联合应用NIV安全有效。综合治疗通过使肺部气体交换正常化、增加组织供氧、降低分流分数和恢复代谢,改善患者的临床状况,减少低氧血症和高碳酸血症、血管内皮功能障碍、代谢紊乱的迹象,增加对身体活动的耐受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Efficiency and safety of the integrated use of medical gases thermal heliox, nitric oxide and molecular hydrogen in patients with exacerbation of chronic obstructive pulmonary disease complicated by hypoxemic, hypercapnic respiratory failure and secondary pulmonary arterial hypertension in the post-COVID period].

Aim: To study the efficacy and safety of the combined use of thermal heliox (t-He/O2), nitric oxide (NO) and molecular hydrogen (H2) in patients with exacerbation of chronic obstructive pulmonary disease (COPD) complicated by hypoxemic, hypercapnic respiratory failure (RF) and secondary pulmonary arterial hypertension (PAH) in the post-COVID period.

Materials and methods: The randomized, comparative, controlled, parallel study included patients (n=100, 52 men and 48 women) with exacerbation of COPD levels of evidence C and D (GOLD 2021-2023) with hypoxemic, hypercapnic respiratory failure and secondary PAH, who had pneumonia caused by SARS-CoV-2 before hospitalization. Patients with similar demographic, clinical, and functional parameters, who received non-invasive ventilation (NIV) and oxygen (O2) along with standard drug therapy, were divided into 5 groups: Group 1 (main): (n=22: 12 men, 10 women, who received t-He/O2, NO, and H2 sequentially); Group 2 (n=20: 10 men, 10 women, who received t-He/O2 and NO); Group 3 (n=20: 11 men, 9 women, who received t-He/O2 and H2); Group 4 (n=18: 10 men, 8 women, who received NO and H2); Group 5 (control) (n=20: 9 men, 11 women). The dynamics of the clinical condition of patients, gas exchange in the lungs, acid-base balance, left-to-right discharge fraction, hemodynamic parameters, and exercise tolerance were assessed.

Results: A positive effect of the complex use of medical gases on the clinical condition of patients, gas exchange parameters in the lungs, metabolism, hemodynamic parameters and exercise tolerance was found in comparison with these parameters in patients who received medical gases separately and with the control group.

Conclusion: The combination of t-He/O2, NO and H2 with simultaneous pathogenetic therapy and NIV in patients with exacerbation of COPD complicated by hypoxemic, hypercapnic RF and secondary PAH in the post-COVID period is safe and more effective compared to groups receiving each medical gas separately. Complex therapy improves the clinical condition of patients, reduces signs of hypoxemia and hypercapnia, vascular endothelial dysfunction, metabolic disorders and increases tolerance to physical activity by normalizing gas exchange in the lungs, increasing oxygen delivery to tissues, reducing the shunt fraction, and restoring metabolism.

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来源期刊
Terapevticheskii Arkhiv
Terapevticheskii Arkhiv 医学-医学:内科
CiteScore
1.40
自引率
33.30%
发文量
171
审稿时长
3-8 weeks
期刊介绍: Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.
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