多沙普仑结合常规疗法治疗慢阻肺并发Ⅱ型呼吸衰竭的效果及对ACO2、SLC16的影响

摘要

Objective To study the effect of multiple therapy combined with conventional therapy in treatment of COPD patients complicated with type Ⅱ respiratory failure and its influence on SLC16 and ACO2.Methods A total of 90 COPD patients complicated with type Ⅱ respiratory failure in our hospital were randomly divided into the observation group and the control group, 45 cases in each group.The control group was given routine treatment, and the observation group was additionally given doxapram treatment.Blood gas indexes, serum inflammatory factors, prognostic factors and skeletal muscle ubiquitin related protein expression were compared between the two groups.Results 7 days after treatment, the effective rate was 93.3% in the observation group, significantly higher than 73.3% in the control group (χ2=14.240, P<0.05).Before treatment, their blood gas indexes (PaO2, PaCO2, PH) showed no significant difference (t(PaO2)=0.990, P>0.05;t(PaCO2)=0.428, P>0.05;t(pH)=0.631, P>0.05).After treatment, PH and PaO2 increased significantly, and PaCO2 decreased significantly in the two groups, and it was more pronounced in the observation group than in the control group (t(PaO2)=9.300, P<0.05;t(PaCO2)=12.813, P<0.05;t(pH)=5.367, P<0.05).Before treatment, The levels of ACO2 and the expression of SLC16 protein showed no significant difference between the two groups (t(ACO2)=0.000, P>0.05;t(SLC16)=0.000, P>0.05), while ACO2 increased significantly and SLC16 decreased significantly, and it was more pronounced in the observation group than in the control group (t(ACO2)=14.000, P<0.05;t(SLC16)=16.602, P<0.05).The incidence of adverse reactions in the observation group was 13.3%, and 17.8% in the control group (χ2=0.329, P>0.05).Conclusion The early application of doxapram can alleviate symptoms, improve the blood gas levels, reduce systemic inflammatory reaction, improve skeletal muscle proteasome pathway and energy metabolism, enhance ACO2 level and reduce SLC16 level in treatment of COPD patients complicated with type II respiratory failure, with less adverse reactions.%目的 探究多沙普仑结合常规治疗对慢性阻塞性肺疾病(chronic Obstructive Pulmonary Disease,COPD)并发Ⅱ型呼吸衰竭的临床疗效,以及对患者线粒体顺乌头酸酶(ACO2)、核糖体蛋白SLC16(SLC16)的影响作用. 方法 选取我院收治的90例慢阻肺并发Ⅱ型呼吸衰竭的患者,随机分成观察组和对照组,每组患者45例,对照组给予常规治疗,观察组在对照组基础上给予多沙普仑治疗.比较两组治疗前后血气指标、血清炎症因子、血清预后因子水平以及骨骼肌泛素相关蛋白表达水平,并比较两组术后并发症发生情况. 结果 治疗7d后,观察组的治疗有效率达93.3%,显著高于对照组的73.3%,两组比较差异显著(χ2=14.240,P<0.05);治疗前两组血气指标(PaO2、PaCO2、pH)比较无显著差异(t(PaO2)=0.990,P>0.05;t(PaCO2)=0.428,P>0.05;t(pH)=0.631,P>0.05),治疗后两组患者PaO2、PH显著升高,PaCO2显著降低,且观察组各指标显著优于对照组,两组比较差异显著(t(PaO2)=9.300,P<0.05;t(PaCO2)=12.813,P<0.05;t(pH)=5.367,P<0.05);治疗前,两组ACO2、SLC16蛋白表达水平比较差异不大(t(ACO2)=0.000,P>0.05;t(SLC16)=0.000,P>0.05),治疗后两组患者ACO2显著升高,SLC16显著降低,且观察组显著优于对照组(t(ACO2)=14.000, P<0.05;t(SLC16)=16.602,P<0.05);观察组不良反应发生率为13.3%,对照组不良反应发生率为17.8%,两组不良反应发生率比较差异无统计意义(χ2=0.329,P>0.05).结论 慢阻肺合并Ⅱ型呼吸衰竭患者早期应用多沙普仑有利于缓解症状、改善血气水平,降低患者的全身炎症反应,改善骨骼肌蛋白酶体途径及能量代谢紊乱,提升了患者的ACO2水平并降低了患者的SLC16水平,不良反应较少,显著改善了患者的预后.