纳络酮对慢性肺源性心脏病失代偿期患者呼吸困难症状改善及相关指标的影响

Effect of naloxone on the symptom of dyspnea and objective indicators in patients with decompensated chronic pulmonary heart disease

目的观察纳络酮对慢性肺源性心脏病失代偿期患者的疗效。方法选取慢性肺源性心脏病失代偿期患者共126名,随机分为试验组与对照组。对照组给予常规抗感染、解痉平喘、扩血管利尿治疗。在此基础上,试验组每日给予纳洛酮1.2 mg静滴,疗程7 d。入院当天、治疗1,3,7 d后次日晨,进行血气分析及测定血浆B型利钠肽(BNP),并行Borg评分。结果治疗1 d后,试验组Borg评分明显高于对照组(P<0.05)。BNP值在治疗后逐渐下降,2组治疗前后比较均有显著性差异(P<0.05),试验组治疗1 d后BNP值下降率明显高于对照组(P<0.05)。试验组治疗3 d后PO2/FiO2明显改善(P<0.05),治疗1 d后PaCO2明显下降(P<0.05)。结论对于以心力衰竭为主要表现的慢性肺心病患者,可以考虑联合纳洛酮治疗。

Objective To study the influence of naloxone on the chronic pulmonary heart disease（CPHD） patients at the subjective perception and objective indicators.Methods A total of 126 patients with decompensated CPHD were randomly divided into two groups： trial group and control group.Trial group had received 1.2 mg of naloxone once a day for seven days in addition to anti-infection,spasmolysis,diuresis and expand blood vessel as control group.The results of Borg recording,arterial blood gas analysis and the plasma concentration of brain natriuretic peptide（BNP） were recorded before treatment and 1,3,7 days after treatment.Results Borg recording was higher in trial group than control group 1-day after treatment.The plasma concentration of BNP declined gradually after treatment.And the radio of decline was much higher in trial group.PO2/FiO2,PaCO2 had not different between the two groups.PO2/FiO2 had improved in trial group at 3-day after treatment,and PCO2 declined obviously at 1-day after treatment.Conclusion To those patients with CPHD,if the most clinical manifestation is heart failure,the treatment combined with naloxone will be recommended.