目的 探討細(xì)辛腦注射液聯(lián)合納絡(luò)酮治療慢性肺心病呼吸衰竭的臨床效果。方法 選取2016年6月-2017年12月衡水市第二人民醫(yī)院收治的98例慢性肺心病呼吸衰竭患者，隨機(jī)分為對照組和治療組，每組各49例。對照組給予鹽酸納洛酮注射液，以0.8 mg為首次負(fù)荷劑量加入生理鹽水15 mL靜脈推注，再將4.0 mg加入生理鹽水250 mL均勻混合后緩慢持續(xù)靜脈滴注，1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注細(xì)辛腦注射液，40 mg加入5%葡萄糖液250 mL充分稀釋后給藥，1次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組臨床癥狀緩解時間。比較兩組治療前后動脈血氧/二氧化碳分壓（pO₂和pCO₂）、酸堿度（pH）、血氧飽和度（SaO₂）、血漿黏度（PV）、紅細(xì)胞聚集指數(shù)（RCAI）、紅細(xì)胞比容（HCT）、紅細(xì)胞沉降率（ESR）、肺動脈收縮壓（PASP）、右室舒張末期內(nèi)徑（RVd）、腦鈉肽（BNP）、心肌肌鈣蛋白I（cTnI）、單核細(xì)胞趨化蛋白-1（MCP-1）、白細(xì)胞介素（IL）-18、血清血管性血友病因子（vWF）和內(nèi)皮素-1（ET-1）水平。結(jié)果 治療后，對照組和治療組的總有效率分別為77.55%、91.84%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組咳嗽、氣促、心悸、肺啰音、水腫臨床癥狀緩解時間均顯著短于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組pO₂、pH、SaO₂值均較治療前顯著增加，但pCO₂、PASP、RVd、BNP、cTnI、PV、RCAI、HCT、ESR、MCP-1、IL-18、ET-1、vWF顯著減少，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組pO₂、pH、SaO₂值高于對照組，pCO₂、PASP、RVd、BNP、cTnI、PV、RCAI、HCT、ESR、MCP-1、IL-18、ET-1、vWF低于對照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 細(xì)辛腦注射液聯(lián)合納絡(luò)酮治療慢性肺心病呼吸衰竭具有較好的臨床療效，可有效減輕患者癥狀，改善心肺功能，調(diào)節(jié)血流變狀態(tài)，抑制炎性反應(yīng)，保護(hù)內(nèi)皮功能，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Asarone Injection combined with naloxone in treatment of chronic pulmonary heart disease with respiratory failure. Methods Patients (98 cases) with chronic pulmonary heart disease with respiratory failure in the Second People's Hospital of Hengshui from June 2016 to December 2017were randomly divided into control (49 cases) and treatment (49 cases) groups. Patients in the control group were administered with Naloxone Hydrochloride Injection, initial dosage of 0.8 mg added with normal saline 15 mLwhich was intravenous injected, then 4.0 mg added with normal saline 250 mL which was slowly continuous intravenous drip, once daily. Patients in the treatment group were iv administered with Asarone Injection on the basis of the control group, 40 mg added with 5% glucose liquid 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and remission times of clinical symptom in two groups were compared. The changes of pO₂, pCO₂, pH, SaO₂, PV, RCAI, HCT, ESR, PASP, RVd, BNP, cTnI, MCP-1, IL-18, vWF, and ET-1 in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 77.55% and 91.84%, respectively, and there was difference between two groups (P < 0.05). After treatment, remission time of cough, breath, heart palpitation, lung, and edema in the treatment group were shorter than those in the control group, and there was difference between two groups (P < 0.05). After treatment, pO₂, pH, and SaO₂ in two groups were significantly increased, but pCO₂, PASP, RVd、BNP, cTnI, PV, RCAI, HCT, ESR, MCP-1, IL-18, ET-1, and vWF in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, pO₂, pH, and SaO₂ in the treatment group were higher than those in the treatment group, but pCO₂, PASP, RVd、BNP, cTnI, PV, RCAI, HCT, ESR, MCP-1, IL-18, ET-1, and vWF were lower than those in the treatment group, and there was difference between two groups (P < 0.05). Conclusion Asarone Injection combined with naloxone has remarkable clinical effect in treatment of chronic pulmonary heart disease with respiratory failure, and can effectively alleviate symptoms, improve the cardiopulmonary function, and can regulate the blood flow, suppress the inflammatory response, also can protect the endothelial function, which has a certain clinical application value.

衡水市重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（2017014040Z）