无创通气配合肺康复治疗对重叠综合征患者免疫功能及炎症因子的影响

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Abstract Objective To investigate the effect of non-invasive ventilation combined with pulmonary rehabilitation under bi-level positive airway pressure (BiPAP) mode on immune function of patients with chronic obstructive pulmonary disease (COPD) accompanied by obstructive sleep apnea hypopnea syndrome (OSAHS) overlap syndrome(OS). Methods A total of 100 patients with COPD-OSAHS OS admitted to People′s Hospital of Jiangmen City from April 2019 to June 2020 were selected as the research objects. All patients were divided into the treatment group and the control group by random number table method，with 50 patients in each group. Patients in the control group were given routine treatment of COPD and OSAHS，while patients in the treatment group were provided with non-invasive ventilation in BiPAP mode on the basis of the control group and pulmonary rehabilitation training. After 6 months of treatment，inflammatory indexes (interleukin-4 [IL-4]，interleukin-6 [IL-6]，tumor necrosis factor-α [TNF-α]) and immune indexes (mature T lymphocyte [CD3+]，induced/helper T cell [CD4+]，inhibitory/cytotoxic T cells [CD8+] and CD4+/CD8+) were compared between the two groups. Results Before treatment，there were no significant differences in the levels of IL-4，IL-6 and TNF-α between the two groups (P＞0.05). After treatment，the levels of IL-4，IL-6 and TNF-α in the treatment group were lower than those in the control group，the differences were statistically significant(P＜0.05). Before treatment，there were no statistically significant differences in CD3+，CD4+，CD8+，CD4+/CD8+ between the two groups (P＞0.05). After treatment，CD3+，CD4+，CD4+/CD8+in the treatment group were higher than those in the control group，while CD8+ was lower than that in the control group，the differences were statistically significant (P＜0.05). Conclusion Non-invasive ventilation combined with pulmonary rehabilitation in BiPAP mode can improve patients′ immune function and immune-related inflammatory factors，and reduce immune and inflammatory damage.

Key words： Chronic obstructive pulmonary disease Obstructive sleep apnea hypopnea syndrome Overlap syndrome Bi-level positive airway pressure ventilation Pulmonary rehabilitation

Received: 04 June 2021

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