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阿片类药物在呼吸疾病中的应用现状

     

摘要

阿片受体及其内源性阿片肽广泛分布于大脑和外周组织,在调节内分泌、疼痛、呼吸、应激反应、体温调节、心血管、胃肠和免疫功能等方面发挥重要作用.相较阿片受体调控呼吸的基础研究,迄今有关阿片类药物对呼吸系统的临床观察总结有限.口服或静脉应用阿片类药物对治疗慢性阻塞性肺疾病难治性呼吸困难有确切疗效,但雾化吸入是否有效仍有争论,对此有必要作深入研究.阿片类药物对晚期肺癌患者具有镇痛、止咳和提高通气功能的作用.阿片类药物可改善阻塞性睡眠呼吸暂停综合征的睡眠质量和呼吸障碍.吸食阿片类药物是否会诱发支气管哮喘,目前还没有定论.阿片类药物在特发性肺纤维化终末期姑息疗法中的应用价值受到关注.%Opioid receptors and endogenous opioid peptides are widely distributed in the brain and peripheral tissue , playing an important role in regulating endocrine ,pain,breathing and stress reaction and body temperature regulation ,cardi-ovascular ,gastrointestinal and immune function .Compared with the basic research on opioid receptor regulating breathing , there is only limited clinical observation summary of the opioids on respiratory system so far .Oral or intravenous application of opioid drugs for the treatment of intractable dyspnea of chronic obstructive pulmonary disease has exact curative effect , while there are still controversies about effect of inhalation of opioids ,therefore it is necessary to make further study .Opioids have the effect of relieving pain , antitussive and improving ventilation function in patients with advanced lung cancer . Opioids can improve sleep quality and respiratory disorders in obstructive sleep apnea syndrome .It has not been determined whether opioids can induce bronchial asthma .The application value of opioid drugs in end-stage palliative therapy for idiopathic pulmonary fibrosis is concerned .

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