无创正压通气对AECOPD合并肺心病患者血气分析、血浆高敏C反应蛋白和N-末端脑钠肽前体的影响  

Effect of non-invasive positive pressure ventilation on plasma hs-CRP and NT-pro BNP in acute exacerbations of AECOPD combined with pulmonary heart disease

作　　者：付会文[1] 许运铎 孙涛[1] 郭安[1] 

机构地区：[1]河北省衡水市第二人民医院呼吸消化科,053000

出　　处：《疑难病杂志》2014年第6期590-591,596,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨无创正压通气对慢性阻塞性肺疾病急性加重(AECOPD)合并肺源性心脏病患者血气分析、血浆高敏C反应蛋白(hs-CRP)和N-末端脑钠肽前体(NT-proBNP)的影响。方法将80例AECOPD合并肺心病患者采用数字表法随机分为2组,每组各40例,其中对照组给予抗感染、止咳、祛痰等常规治疗,观察组在此基础上加用无创正压机械通气治疗,10 d为1个疗程,比较2组治疗前后血气分析及血浆hs-CRP和NT-proBNP水平变化。结果观察组治疗后血液pH值、PaO_2、PaCO_2和SaO_2分别为(7.42±0.06)、(70.02±3.66)mm Hg、(61.34±4.31)mm Hg和(92.55±4.83)%,较治疗前的(7.20±0.05)、(48.67±3.48)mm Hg、(88.94±4.43)mm Hg和(79.83±3.64)%均显著改善(P<0.05),且改善程度优于对照组治疗后的(7.28±0.05)、(58.90±3.74)mm Hg、(72.66±4.43)mm Hg和(81.32±4.17)%(P<0.05);观察组治疗后血浆hs-CRP和NT-proBNP水平分别为(7.36-±-1.02)ng/L和(112.80±10.03)ng/L,均较治疗前的(28.10±2.36)ng/L和(280.73±13.23)ng/L显著降低(P<0.05),且降低程度优于对照组治疗后的(14.44±1.63)ng/L和(175.61±10.87)ng/L(P<0.05)。结论无创正压通气治疗AECOPD合并肺心病疗效显著,可明显降低患者血浆hs-CRP和NT-proBNP水平,具有较好的临床应用价值。Objective To investigate the effect of non invasive positive pressure ventilation on plasma high sensitive C-reactive protein（hs-CRP） and N-terminal pro brain natriuretic peptide（NT-pro BNP） of acute exacerbations of chronic obstructive pulmonary disease （AECOPD） combined with pulmonary heart disease. Methods 80 cases of patients with pulmonary heart disease with AECOPD were randomly divided into 2 groups, 40 cases in each group, the control group received rou- tine treatment of anti infection and cough, expectorant, based on these treatment, the observation group combined the use of noninvasive positive pressure ventilation therapy, l0 d as 1 course of treatment, compared 2 groups＇before and after treatment of blood gas analysis and plasma hs-CRP and NT-proBNP levels. Results Obsmwation group after treatment, blood pH, PaO2, PaCO2 and SaO2 were （7.42 ± 0.06）, （70.02 ± 3.65） mmHg, （61.34 ± 4.31） mmHgand （92.55±4.83）% respectively, compared with those before treatment of （7.20 ±0.05 ） , （48.57 ±3.48 ） mm Hg, （88.94 ± 4.43 ）mm Hg and （79.83 ±3.64 ） %, these indexes was significantly improved （ P 〈 0.05 ）, and the degree of improvement is better than the control group after treatment of （7.28 ±0.05）, （58.90 ±3.74） mm Hg, （72.66 ±4.43） mm Hg and （81.32 ±4.17）% （P 〈 0.05 ） ; the observation group after treatment, the plasma hs-CRP and NT-proBNP levels were （7.36 ± 1.02） ng/L and （ 112.80 ± 10.03） ng/L, these indexes were lower than before treatment （28.10 ± 2.36） ng/L and （ 280.73 ± 13.23 ） ng/ L, these indexes was significantly reduced （ P 〈 0.05） , and the extent of decrease was better than the control group after treatment of （14.44 ±1.63） ng/L and （175.61 ± 10.87） ng/L （ P 〈0.05）. Conclusion Noninvasive positive pressure ventilation in the treatment of AECOPD with pulmonary heart disease has significantly curative effect, it can significantly reduce the plasma hs-CRP and NT-proBNP level,

关 键 词：无创正压通气 慢性阻塞性肺疾病急性加重 肺源性心脏病 血气分析 高敏C反应蛋白 N末端脑钠肽前体 

分 类 号：R563.9[医药卫生—呼吸系统]