摘要
目的探讨盐酸纳洛酮在慢性阻塞性肺疾病合并呼吸衰竭(COPD-FAR)治疗中的应用效果。方法我院收治的COPD-FAR患者128例,按随机数字表法分为研究组与对照组各64例,对照组行常规治疗+无创正压通气治疗,研究组行常规治疗+无创正压通气+盐酸纳洛酮治疗。观察两组治疗前后pH、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)等血气分析指标,1秒用力呼气量(FEV1)、最大肺活量(PEF)、1秒用力呼气量/用力肺活量(FEV1/FVC)等肺功能指标,血清白介素-13(IL-13)、IL-18、高敏C反应蛋白(hs-CRP)、前列腺素E2(PGE2)、可溶性细胞间黏附分子-1(sICAM-1)等炎性因子,血清超氧化物歧化酶(SOD)、丙二醛(MDA)等指标。结果治疗后,研究组PaO_2、FEV1、PEF、FEV1/FVC、SOD均高于对照组,PaCO_2、IL-13、IL-18、hs-CRP、PGE2、sICAM-1、MDA低于对照组(P<0.05)。两组pH与治疗前比较,差异无统计学意义(P>0.05)。结论盐酸纳洛酮治疗COPD-FAR可有效改善患者血气指标及肺功能,清除炎性因子,保护肺组织,疗效显著。
Objective To investigate the application effect of naloxone hydrochloride in the treatment of chronic obstructive pulmonary disease complicated with failure of respiration（ COPD-FAR）.Methods A total of 128 cases of COPD-FAR patients admitted to our hospital were divided into experimental or control group by using random number table method,64 in each group.The control group received conventional therapy plus non-invasive positive pressure ventilation treatment. The experimental group received conventional therapy,non-invasive positive pressure ventilation and naloxone hydrochloride treatment. Before and after treatment,pH value,PaO2,PaCO2 and other blood gas analysis indexes,forced expiratory volume in one second（ FEV1）,peak expiratory flow（ PEF）,forced expiratory volume in 1 second/forced vital capacity（ FEV1/FVC） and other lung function indices,serum interleukin 13（ IL-13）,IL-18,high sensitive C reactive protein（ hs-CRP）,prostaglandin E2（ PGE2）,soluble intercellular adhesion molecule-1（ sICAM-1） and other inflammatory factors,serum superoxide dismutase（ SOD）,malondialdehyde（ MDA） and other indicators were observed in the two groups.Results After treatment,the levels of PaO2,FEV1,PEF,FEV1/FVC and SOD were higher while the levels of PaCO2,IL-13,IL-18,hs-CRP,PGE2,sICAM-1 and MDA were lower in the experimental group than those in the control group（ P〈0. 05）.There was no statistical significance in pH values before and after treatment in the both groups（ P〈0. 05）. Conclusion Naloxone hydrochloride in the treatment of COPD-FAR can effectively improve the blood gas indexes and lung function,remove the inflammatory factors and protect the lung tissue.Its curative effect is significant.
作者
孟小蓉
杨娇
张磊
MENG Xiao-rong;YANG Jiao;ZHANG Lei(Geriatric Department,The First Affiliated Hospital,Chengdu Medical College,Chengdu 610500,China)
出处
《实用医院临床杂志》
2018年第4期105-108,共4页
Practical Journal of Clinical Medicine
关键词
盐酸纳洛酮
无创正压通气
慢性阻塞性肺疾病
呼吸衰竭
Naloxone hydrochloride
Non-invasivc positive pressure ventilation
Chronic obstructive pulmonary disease
Failure of respiration
