纳洛酮联合无创通气对老年慢性阻塞性肺疾病合并呼吸衰竭病人心功能的影响及疗效

Clinical efficacy and effects of naloxone combined with noninvasive ventilation on the cardiac function in elderly patients with chronic obstructive pulmonary disease complicated with respiratory failure

目的探讨纳洛酮联合无创通气对老年慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并呼吸衰竭病人的疗效及血清N端脑钠肽前体(NT-pro BNP)、高敏肌钙蛋白(hs-TNT)、胱抑素C(Cys C)水平的影响。方法选择2014年2月至2017年2月我院收治的80例COPD合并呼吸衰竭老年病人,随机分成对照组和治疗组,各40例。对照组给予无创通气治疗,治疗组给予纳洛酮联合无创通气治疗,2组均治疗7 d。比较并评价2组病人的临床疗效。检测并比较2组病人治疗前后血清NT-pro BNP、hs-TNT及Cys C水平。结果治疗组总有效率明显高于对照组,差异具有统计学意义(χ2=5.165,P=0.023)。治疗后,2组病人血清NTpro BNP、hs-TNT、Cys C水平均明显低于治疗前,且治疗组明显低于对照组,差异均具有统计学意义(P<0.05)。结论纳洛酮联合无创通气治疗COPD合并呼吸衰竭老年病人的临床疗效显著,有利于病人心功能和心肌细胞的恢复,值得在临床上推广应用。

Objective To study the clinical efficacy and effects of naloxone combined with noninvasive ventilation on serum N-terminal pro-brain natriuretic peptide（ NT-pro BNP）,high sensitive troponin（ hs-TNT）,cystatin C（ Cys C） in elderly patients with chronic obstructive pulmonary disease（ COPD） complicated with respiratory failure. Methods A total of 80 elderly patients with COPD complicated with respiratory failure in our hospital from February 2014 to February 2017 were enrolled in this study.The subjects were divided into the control group（ n = 40） and the treatment group（ n = 40）randomly.The control group was treated with noninvasive ventilator,and the treatment group was treated with naloxone combined with noninvasive ventilator. Two groups were treated for 7 days. The clinical efficacy of two groups were compared. The serum levels of NT-pro BNP,hs-TNT and Cys C of two groups before and after treatment were detected and compared. Results The total efficacy rate of the treatment group was 95. 00%,compared with 77. 50% of the control group（ χ2= 5. 165,P = 0. 023）. After treatment,the serum levels of NT-pro BNP,hs-TNT and Cys C in two groups were significantly lower than before,especially in the treatment group（ P 0. 05）. Conclusions Naloxone combined with noninvasive ventilator have a good clinical efficacy and effects on cardiac function in elderly patients with COPD complicated with respiratory failure,which is worthy of clinical application.