纳美芬联合NIPPV治疗老年COPD合并重症Ⅱ型呼吸衰竭的疗效

Effect of Nalmefene combined with NIPPV on Elderly COPD Complicated with Severe Type Ⅱ Respiratory Failure and Its Effect on the Level of Serum

目的探讨纳美芬联合无创正压机械通气治疗老年慢性阻塞性肺疾病合并重症Ⅱ型呼吸衰竭的疗效及对患者血清人Clara细胞分泌蛋白、巨噬细胞刺激蛋白水平的影响。方法选取2017年6月1日-2019年6月30日某院收治的老年COPD合并重症Ⅱ型呼吸衰竭患者84例,采用随机数字表法分为对照组和观察组,每组各42例。2组均采用常规治疗,对照组予以NIPPV治疗,在此基础上观察组予以纳美芬治疗。比较2组治疗前及治疗7天后两组肺功能指标、血气参数及血清CC16、MSP水平,同时比较治疗期间2组不良反应发生情况。结果治疗7天后观察组用力呼吸量、第1秒用力呼吸量及第1秒用力呼吸量/用力呼吸量均显著高于对照组(P<0.05)。治疗7天后2组PaO_2及PH值显著高于对照组,PaCO_2显著低于对照组(P<0.05)。治疗7天后观察组血清CC16水平均显著高于对照组,MSP水平显著低于对照组(P<0.05)。观察组和对照组不良反应发生率(7.14%VS4.76%)比较差异无统计学意义(χ^2=0.213,P=0.645)。结论 纳美芬联合NIPPV治疗老年COPD合并重症Ⅱ型呼衰可明显改善肺功能及血气指标,提高血清CC16水平,降低血清MSP水平,且安全可靠,值得临床推广使用。

Objective To investigate the effect of Nalmefene combined with NIPPV on elderly COPD complicated with severe typeⅡrespiratory failure and its effect on the level of serum CC16 and MSP.Methods From June 2017 to June 2019,84 patients with COPD complicated with severe typeⅡrespiratory failure were treated in our hospital.They were divided into control group and observation group by random digital table method,each group was 42 cases.Both groups were treated with routine treatment,and the control group was treated with NIPPV.On this basis,the observation group was treated with Namefene.The pulmonary function index,blood gas parameters and the level of serum CC16 and MSP of the two groups were compared before and after 7 days of treatment,and the adverse reaction occurred were also compared between two groups during treatment.Results After 7 days of treatment,FVC,FVE1 and FVE1/FVC in the observation group were significantly higher than those in the control group(P<0.05).After 7 days of treatment,the PaO2 and pH values of the two groups were significantly higher than those of the control group,and PaCO2 was significantly lower than that of the control group(P<0.05).After 7 days of treatment,the level of serum CC16 in the observation group was significantly higher than that of the control group,and the level of MSP was significantly lower than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(7.14%VS4.76%)(χ^2=0.213,P=0.645).Conclusions Namefene combined with NIPPV in the treatment of elderly COPD with severe typeⅡrespiratory failure could significantly improve lung function and blood gas index,improve serum CC16 level,reduce serum MSP level,and be safe and reliable,which was worthy of clinical application.