噻托溴铵辅助治疗呼吸窘迫综合征对血清NO与VEGF水平的影响研究

摘要 目的：探讨与研究噻托溴铵辅助治疗呼吸窘迫综合征对血清一氧化氮(Nitric oxide，NO)与血管内皮生长因子(vascular endothelial growth factor，VEGF)水平的影响。方法：2016年9月到2020年9月选择在本院进行急诊的呼吸窘迫综合征患者84例，根据随机数字表法把患者分为噻托溴铵组与对照组各42例。对照组给予鼻塞式持续气道正压通气治疗，噻托溴铵组在对照组治疗的基础上给予噻托溴铵治疗，两组都治疗观察2 w，检测血清NO与VEGF表达变化情况。结果：治疗后噻托溴铵组的总有效率为97.6 %，高于对照组的85.7 % (P<0.05)。两组治疗后的氧合指数高于治疗前(P<0.05)，噻托溴铵组高于对照组(P<0.05)。两组治疗后的FEV₁与FVC值高于治疗前(P<0.05)，噻托溴铵组高于对照组(P<0.05)。两组治疗后的血清NO值高于治疗前(P<0.05)，血清VEGF值低于治疗前(P<0.05)，噻托溴铵组与对照组对比差异也都有统计学意义(P<0.05)。结论：噻托溴铵辅助治疗呼吸窘迫综合征能抑制血清VEGF的表达与促进NO的释放，改善患者的肺功能与氧合状况，从而提高治疗效果。

Effects of Tiotropium Bromide in Adjuvant Treatment of Respiratory Distress Syndrome on Serum NO and VEGF Levels

ABSTRACT Objective: To explore and study the effects of tiotropium bromide adjuvant treatment of respiratory distress syndrome on serum nitric oxide (NO) and vascular endothelial growth factor (VEGF) levels. Methods: From September 2016 to September 2020, 84 cases of patients with respiratory distress syndrome were selected for emergency treatment in this hospital. All the cases were divided into tiotropium bromide group and control group with 42 cases each groups accorded to the random number table method. The control group were treated with nasal congestion continuous positive airway pressure, and the tiotropium bromide group were treated with tiotropium bromide on the basis of the control group. Both groups were treated and observed for 2 weeks, and serum NO and VEGF expression changes were detected. Results: After treatment, the total effective rates of the tiotropium bromide group were 97.6 %, which were higher than 85.7 % of the control group (P<0.05). The oxygenation index of the two groups after treatment were higher than that before treatment (P<0.05), and the tiotropium bromide group were higher than the control group (P<0.05). The FEV₁ and FVC values of the two groups after treatment were higher than those before treatment (P<0.05), and the tiotropium bromide group were higher than the control group (P<0.05). The serum NO value of the two groups after treatment were higher than before treatment (P<0.05), and the serum VEGF value were lower than before treatment (P<0.05), the difference compared between the tiotropium bromide group and the control group were also statistically significant (P<0.05). Conclusion: Tiotropium bromide adjuvant treatment of respiratory distress syndrome can inhibit the expression of serum VEGF and promote the release of NO, improve the patient''s lung function and oxygenation status, thereby enhance the therapeutic effect.