摘要
目的:探究纳美芬与纳洛酮联合无创正压机械通气(NPPV)治疗慢性阻塞性肺疾病(COPD)并Ⅱ型呼吸衰竭的疗效及对患者肺功能和血气指标的影响。方法:采用随机数字表法将2018年1月~2019年1月期间我院100例COPD并Ⅱ型呼吸衰竭患者随机分为观察组和对照组各50例,两组均接受常规解痉、祛痰、抗感染、营养支持、维持水电解质平衡等常规基础治疗以及NPPV治疗,观察组在此基础上联合应用纳美芬,对照组在此基础上联合应用纳洛酮。对比两组患者治疗总有效率,记录其治疗前及治疗14d后患者肺功能相关指标[大呼气峰流速值(PEF)、肺总容量(TLC)、第1秒用力呼气容积(FEV1)、肺活量50%时的呼气流速(PEF50)、肺活量25%时的呼气流速(PEF25)]、动脉血气指标[二氧化碳分压(PaCO^(2))、血氧张力(PaO^(2))、氧饱和度(SaO^(2))、酸碱度(PH)]以及血清标志物[肺表面活性相关蛋白D(SP-D)、肺部活化调节趋化因子(PARC/CCL18)]水平。结果:观察组患者治疗总有效率明显高于对照组;治疗48h后,两组患者PEF、TLC、PEF50、PEF25、FEV1均较治疗前明显改善,且观察组变化幅度更大;治疗48h后,两组患者PaCO^(2)均明显低于治疗前,PaO^(2)、SaO^(2)、PH均明显高于治疗前,且观察组以上指标变化幅度均大于对照组;治疗48h后,两组患者血清SP-D、PARC/CCL18水平均较治疗前有显著降低,且观察组低于对照组。结论:纳美芬与纳洛酮联合NPPCOPD合并Ⅱ型呼吸衰竭患者均可有效缓解症状,改善肺功能,但纳美芬疗效更佳。
Objective To explore the efficacy of nalmefene and naloxone combined with non-invasive positive pressure mechanical ventilation(NPPV)in the treatment of chronic obstructive pulmonary disease(COPD)with type II respiratory failure and its influence on lung function and blood gas indexes.Methods 100 patients with COPD and type II respiratory failure in our hospital from January 2018 to January 2019 were randomly divided into observation group and control group by random number table method,with 50 cases in each group.The two groups were given routine basic treatments of routine spasmolysis,eliminating phlegm,anti-infection,nutritional support and maintaining water and electrolyte balance and NPPV therapy,and observation group was combined with nalmefene on this basis,and control group was combined with naloxone on this basis.The total effective rate of treatment was compared between the two groups.The lung function-related indicators[peak expiratory flow rate(PEF),total lung capacity(TLC),forced expiratory volume in 1 second(FEV1),expiratory flow rate at 50%lung capacity(PEF50),expiratory flow rate at 25%lung capacity(PEF25)],arterial blood gas indexes[partial pressure of carbon dioxide(PaCO^(2)),blood oxygen tension(PaO^(2)),oxygen saturation(SaO^(2)),pH]and serum markers[surfactant-associated protein D(SP-D),Pulmonary activation regulated chemokine/chemokine ligand-18(PARC/CCL18)]were recorded before treatment and after 14d of treatment.Results The total effective rate of treatment in observation group was significantly higher than that in control group.After 48h of treatment,the PEF,TLC,PEF50,PEF25 and FEV1 were significantly improved in the two groups,and the changes were larger in observation group.After 48h of treatment,the PaCO^(2)in the two groups was significantly lower than that before treatment while the PaO^(2),SaO^(2)and PH were significantly higher than those before treatment,and the changes of the above indicators in observation group were larger than those in control group.After 48h of treatment,the serum levels of SP-D and PARC/CCL18 in the two groups were significantly lower than those before treatment,and the levels in observation group were lower than those in control group.Conclusion Nalmefene and naloxone combined with NPPV for patients with COPD and type II respiratory failure can alleviate symptoms and improve lung function,but nalmefene has better efficacy.
作者
明立亮
吴毓霞
吴勇
Ming Li-liang;Wu Yu-xia;Wu Yong(Department of pharmacy,People’s Hospital of Wanning Hainan,Wanning 571500,China;Department of Respiratory Medicine,People’s Hospital of Wanning Hainan,Wanning 571500,China)
出处
《晓庄学院学报（医学版）》
2021年第4期282-285,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
纳美芬
纳洛酮
无创正压机械通气
慢性阻塞性肺疾病
Ⅱ型呼吸衰竭
肺功能
血气指标
nalmefene
naloxone
non-invasive positive pressure mechanical ventilation
chronic obstructive pulmonary disease
type II respiratory failure
lung function
blood gas indexes
