纳洛酮治疗AECOPD伴Ⅱ型呼吸衰竭患者的效果分析

Effect of Naloxone on Patients with AECOPD and Type Ⅱ Respiratory Failure

目的:探讨纳洛酮治疗慢性阻塞性肺疾病急性加重期(AECOPD)伴Ⅱ型呼吸衰竭患者的效果。方法:选取2019年3月-2020年10月江门市新会区人民医院收治的100例AECOPD伴Ⅱ型呼吸衰竭患者,采用随机数字表法分为试验组和对照组,每组50例。两组均予以无创正压通气、抗感染等治疗措施,试验组同时给予纳洛酮辅助治疗。比较两组临床疗效,治疗前、治疗48 h后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))、pH值、心率(HR)、呼吸频率(RR)及血清C反应蛋白(CRP)、白细胞介素-10(IL-10)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)。结果:试验组治疗48 h后效果优于对照组(P<0.05)。两组治疗前PaO_(2)、PaCO_(2)、SaO_(2)、pH值、HR、RR比较,差异均无统计学意义(P>0.05);试验组治疗48 h后PaO_(2)、SaO_(2)、pH值均高于对照组,PaCO_(2)、HR、RR均低于对照组(P<0.05)。两组治疗前血清CRP、IL-10、IL-18、TNF-α水平比较,差异均无统计学意义(P>0.05);试验组治疗48 h后血清IL-10高于对照组,血清CRP、IL-18、TNF-α水平均低于对照组(P<0.05)。结论:纳洛酮治疗AECOPD伴Ⅱ型呼吸衰竭患者能显著改善血气指标水平、减轻炎症反应、提高临床治疗效果。

Objective:To explore the effect of Naloxone in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and type Ⅱ respiratory failure.Method:A total of 100 patients with AECOPD and type Ⅱ respiratory failure admitted to Jiangmen City Xinhui District People’s Hospital from March 2019 to October 2020 were selected and divided into the test group and the control group by the random number table method,50 cases in each group.Two groups were given noninvasive positive pressure ventilation,anti-inflammatory and other treatment measures,and the test group was given Naloxone adjuvant therapy at the same time.The clinical curative effect,arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),blood oxygen saturation(SaO_(2)),pH value,heart rate(HR),respiratory rate(RR),serum C reactive protein(CRP),interleukin-10(IL-10),interleukin-18(IL-18),tumor necrosis factor-α(TNF-α) before treatment and 48 h after treatment were compared between two groups.Result:The effect of the test group after 48 h of treatment was better than that of the control group(P<0.05).There were no significant differences in PaO_(2),PaCO_(2),SaO_(2),pH value,HR and RR between two groups before treatment(P>0.05);the PaO_(2),SaO_(2) and pH value of the test group after 48 h of treatment were higher than those of the control group,and the PaCO_(2),HR,and RR were lower than those of the control group(P<0.05).There were no significant differences in serum CRP,IL-10,IL-18 and TNF-α between two groups before treatment(P>0.05);the serum IL-10 level of the test group after 48 h of treatment was higher than that of the control group,and the serum CRP,IL-18,and TNF-α levels were lower than those of the control group(P<0.05).Conclusion:Naloxone in the treatment of patients with AECOPD and type Ⅱ respiratory failure can significantly improve blood gas levels,reduce inflammatory response and improve clinical treatment.