无创正压通气治疗联合纳洛酮对COPD并发呼吸衰竭患者血清学指标、血气指标和呼吸功能的影响分析

Effect of noninvasive positive pressure ventilation combined with naloxone on serological parameters,blood gas indexes and respiratory function in patients with COPD complicated with respiratory failure

目的分析研究无创正压通气(NIPPV)治疗联合纳洛酮对慢性阻塞性肺疾病(COPD)并发呼吸衰竭(RF)患者血清学指标、血气指标和呼吸功能的影响。方法 152例COPD并发RF患者,按照随机数字表法分为研究组(A组)和对照组(B组),各76例。B组接受常规治疗的同时给予NIPPV治疗,A组在B组的基础上使用纳洛酮治疗。对比分析两组患者治疗后的临床疗效、血清学指标水平及血气指标和呼吸功能。结果治疗后,A组总有效率为92.11%,明显高于B组的80.26%,差异具有统计学意义(P<0.05)。治疗后,A组可溶性细胞间粘附分子-1(sICAM-1)及白细胞介素-18(IL-18)、前列腺素E_2(PGE_2)水平均低于B组,差异具有统计学意义(P<0.05)。治疗后与B组比较,A组的pH、氧分压(PaO_2)水平明显升高,二氧化碳分压(PaCO_2)水平明显降低,差异具有统计学意义(P<0.05)。治疗后,两组呼吸功能指标水平比较,差异具有统计学意义(P<0.05)。结论 NIPPV治疗联合纳洛酮对COPD并发RF患者临床疗效确切,能有效优化患者的血清学指标水平、血气指标水平和呼吸功能,值得临床继续探讨。

Objective To analyze and study the effect of noninvasive positive pressure ventilation （NIPPV） combined with naloxone on serological parameters, blood gas indexes and respiratory function in patients with chronic obstructive pulmonary disease （COPD） complicated with respiratory failure （RF）. Methods A total of 152 patients with COPD complicated with RF were divided by random number table method into research group （group A） and control group （group B）, with 76 cases in each group. Group B received conventional therapy and NIPPV therapy, and group A received naloxone for treatment on the basis of group A. Comparison and analysis were made on clinical efficacy and serological parameters after treatment, and blood gas index and respiratory function between two groups. Results After treatment, group A had obviously higher total effective rate as 92.11% than 80.26% in group B, and the difference was statistically significant （P〈0.05）. After treatment, group A had lower soluble intercellular adhesion molecule 1 （sICAM--1） and interleukin 18 （IL-18） and prostaglandin E2 （PGE2） levels than group B, and the difference was statistically significant （P〈O.05）. After treatment, group A had obviously higher pH, oxygen partial pressure （PaO2） and lower partial pressure of carbon dioxide （PaCO2）, comparing with group B, and the difference was statistically significant （P〈0.05）. After treatment, both groups had statistically significant difference in respiratory function indicators （P〈O.05）. Conclusion NIPPV combined with naloxone shows affirmative clinical efficacy in the treatment Of patients with COPD complicated with RF. It can optimize the serum level, blood gas index and respiratory fundtion of the patients, and is＇w0rthy of further clinical investigation.