纳洛酮联合无创呼吸机对慢性阻塞性肺疾病合并慢性呼吸衰竭的影响  

The influence of naloxone combined with non-invasive ventilator on chronic obstructive pulmonary disease with chronic respiratory failure

作　　者：吕美珍 谢靖红[2] 张崇荣 LV Mei-zhen;XIE Jing-hong;ZHANG Chong-rong(Qingdao Hospital of Traditional Chinese Medicine/Qingdao Hiser Hospital,Qingdao 266033,China;Qingdao Eighth People’s Hospital,Qingdao 266033,China)

机构地区：[1]青岛市中医医院/市海慈医院,山东青岛266033 [2]青岛市第八人民医院,山东青岛266100

出　　处：《实用医院临床杂志》2021年第6期142-145,共4页Practical Journal of Clinical Medicine

基　　金：山东省科研计划基金资助项目(编号:2019D01206)。

摘　　要：目的分析纳洛酮(NX)联合无创呼吸机(NIV)治疗慢性阻塞性肺疾病(COPD)合并慢性呼吸衰竭(RF)对患者血气分析指标、急性生理功能和慢性健康状况评分(APACHEⅡ)变化的影响。方法将92例COPD合并RF患者按随机数字表法分为NIV组和试验组各46例,两组均予以常规治疗,NIV组在常规治疗上加以NIV治疗,试验组在NIV组上加以NX治疗,治疗5 d,比较两组治疗前后血气分析指标、APACHEⅡ评分、格拉斯昏迷评分(GCS)、凋亡相关微粒蛋白(ASC)、半胱氨酸天冬氨酸蛋白酶1(caspase-1)mRNA表达的变化情况,并统计治疗后总好转率,观察不良反应情况。结果试验组治疗总好转率高于NIV组(P<0.05);治疗后两组动脉血血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、GCS评分升高,动脉血二氧化碳分压(PaCO_(2))、APACHEⅡ评分及ASC、caspase-1 mRNA表达降低,且试验组SaO_(2)、PaO_(2)、GCS评分高于NIV组,PaCO_(2)、APACHEⅡ评分及ASC、caspase-1 mRNA表达低于NIV组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论NX联合NIV治疗COPD合并RF患者疗效显著,可明显改善患者血气情况,降低APACHEⅡ评分,下调ASC、caspase-1表达,促进患者疾病转归。Objective To analyze the influence of naloxone(NX)combined with non-invasive ventilator(NIV)on blood gas analysis indexes and Acute Physiology and Chronic Health Evaluation(APACHEⅡ)score in the treatment of chronic obstructive pulmonary disease(COPD)with chronic respiratory failure(RF).Methods Ninety-two patients with COPD and RF were divided into a NIV group and an experimental group according to the random number table method,46 in each group.The two groups were treated with conventional therapy,and the NIV group was treated with NIV based on conventional therapy and the experimental group was added with NX on the basis of the NIV group.The therapy course was 5 days.The blood gas analysis indexes,APACHEⅡscore,Glasgow Coma Scale(GCS),and mRNA expressions of apoptosis-associated speck-like protein containing CARD(ASC)and caspase-1 were compared before and after treatment between the two groups.The total improvement rate after treatment was statistically analyzed and the adverse reactions were observed.Results The total improvement rate in the experimental group was significantly higher than that in the NIV group(P<0.05).After treatment,the arterial blood oxygen saturation(Sa O_(2)),arterial partial pressure of oxygen(PaO_(2))and GCS score were significantly increased in the two groups while the arterial partial pressure of carbon dioxide(PaCO_(2)),APACHEⅡscore,and mRNA expressions of ASC and caspase-1 were significantly decreased.The Sa O_(2),PaO_(2) and GCS score in the experimental group were significantly higher than those in the NIV group while the PaCO_(2),APACHEⅡscore and mRNA expressions of ASC and caspase-1 were significantly lower than those in the NIV group(P<0.05).There was no statistical difference in the incidence rate of adverse reactions between the two group(P>0.05).Conclusion NX combined with NIV has a significant efficacy on COPD with RF It can significantly improve the blood gas status,reduce the APACHEⅡscore,down-regulate the expressions of ASC and caspase-1,and promote the disease o

关 键 词：纳洛酮 无创呼吸机 慢性阻塞性肺疾病 慢性呼吸衰竭 APACHEⅡ评分 

分 类 号：R563.8[医药卫生—呼吸系统] R563.9[医药卫生—内科学]