早期无创正压通气对慢性阻塞性肺疾病急性发作并呼吸衰竭患者血清N末端脑钠肽前体及超敏C反应蛋白的影响  

Effect of noninvasive positive pressure ventilation on Brain Natriuretic Peptide and high sensitive C-reactive protein of acute exacerbation of chronic obstructive pulmonary disease patients with respiratory failur

作　　者：孙丽 杨欣荣 杨勇 刘琴 

机构地区：[1]上海市青浦区中医医院呼吸科,201700

出　　处：《中国综合临床》2014年第12期1252-1255,共4页Clinical Medicine of China

基　　金：上海市青浦区卫生局科研课题（W2013-07）

摘　　要：目的 观察早期联合应用双水平无创正压通气（BiPAP）治疗对慢性阻塞性肺疾病急性发作（AECOPD）并呼吸衰竭患者血清N末端脑钠肽前体（NT-pro BNP）及血清超敏C反应蛋白（hs-CRP）的影响.方法 将100例AECOPD并呼吸衰竭患者应用计算机随机分成研究组和对照组各50例.两组均给予抗感染、舒张支气管、止咳化痰、氧疗等常规治疗.研究组在常规治疗基础上增加BiPAP呼吸机辅助治疗.在治疗前及治疗3d分别抽取患者的静脉血标本,测定血清NT-pm BNP和hs-CRP浓度进行比较分析,并对两组住院费用及住院时间进行比较.结果 治疗后研究组及对照组血清NT-pro BNP水平分别为（105.79 ±4.56）、（113.33±3.26） ng/L,差异有统计学意义（t=3.03,P＜0.05）;血清hs-CRP水平分别为（10.83±16.35）、（26.39±26.87） mg/L,差异有统计学意义（t=-3.44,P＜0.05）.研究组住院时间及住院费用均较对照组减少[（11.15±1.86）、（12.78±2.25）d,（6 659.11±1 609.49）、（8 031.31±1 449.79）元,t值分别为-3.87、-4.38,P均＜0.05].结论 AECOPD并呼吸衰竭患者早期联合应用BiPAP治疗,能使血清NT-pro BNP及hs-CRP水平下降更快,病情更快缓解;对患者病情监测及判断临床疗效有一定价值.Objective To investigate the concentrations of serum N-terminal brain natriuretic peptide （NT-pm BNP） and high-sensitivity C-reactive protein （hs-CRP） of acute exacerbation of chronic obstrnctive pulmonary disease（AECOPD） patients treated by bi-level positive airway pressure（BiPAP） for with respiratory failure.Methods A total of 100 respiratory failure in patients with AECOPD were divided into study group and control group,and 50 cases of each group.Patients in study group were received the conventional treatment（anti infection,diastolic bronchial,cough and phlegm and oxygen therapy） combined with BiPAP therapy,while in control group were received the conventional treatment.Blood samples were drawn at beginning and 3 d later.Serum hs-CRP and NT-pro BNP levels were determined,and the expenses and duration of hospitalization of two groups were compared.Result After treatment,the level of serum NT-pro BNP in study group and control group were （105.79 ± 4.56） ng/L and （113.33 ± 3.26） ng/L,and the difference was statistically signifi cant （t =3.03,P 〈 0.05）.The serum hs-CRP levels were （10.83 ± 16.35） mg/L and （26.39 ± 26.87） mg/L in study and control group,and the differences were statistically significant （t =-3.44,P 〈 0.05）.The expenses and duration of hospitalization in study group were both less than those in control group（（11.15 ± 1.86） d vs.（12.78±2.25） d;（6 659.11 ±1 609.49） yuan vs.（8 031.31 ±1 449.79） yuan;t=-3.87,-4.38;P 〈0.05）.Conclusion Early BiPAP therapy in AECOPD patients with respiratory failure in patients is showed that NT-pro BNP and hs-CRP levels faster decrease and disease is recovery remission,which suggests that NTpro BNP or BNP for AECOPD patients and respiratory failure condition monitoring,clinical efficacy have some clinical value.

关 键 词：慢性阻塞性肺疾病 双水平无创正压通气 N末端脑钠肽前体 超敏C反应蛋白 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]