无创机械通气对慢性肺心病并发呼吸衰竭患者血浆BNP和ET-1水平的影响  

The effect of noninvasive mechanical ventilation on the levels of serum in patients with BNP and ET-1 chronic pulmonary heart disease complicated with respiratory failure

作　　者：陈雄[1] 陈翠霞[2] 张静[1] 叶建华[1] 林士军[1] 刘玉春[1] 

机构地区：[1]深圳市龙岗区人民医院呼吸内科,广东518000 [2]深圳市龙岗区人民医院体检科,广东518000

出　　处：《中国临床新医学》2015年第10期946-949,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨无创机械通气对慢性肺心病并发呼吸衰竭患者血浆脑钠钛(BNP)和内皮素(ET-1)水平的影响。方法选取慢性肺心病并发呼吸衰竭患者80例,随机分为实验组和对照组各40例。对照组给予常规呼吸内科治疗,实验组在内科治疗基础上给予无创机械通气。对比观察72 h后两组患者的临床疗效、血气分析及BNP和ET-1水平变化。结果治疗72 h后,实验组患者的临床症状、体征以及血气分析结果改善明显,其中Sa O2、Pa O2显著升高,Pa CO2、HR、RR显著下降(P<0.05),且明显优于对照组(P<0.05)。实验组患者血清BNP和ET-1水平随着患者缺氧症状以及二氧化碳潴留的改善而明显下降(P<0.01或P<0.05),且明显优于对照组(P<0.05);BNP与ET-1水平呈正相关;BNP和ET-1与血氧分压呈负相关,与Pa CO2呈正相关。结论无创机械通气改善慢性肺心病并发呼吸衰竭患者的通气功能的同时,还可降低血清BNP和ET-1的水平,提高临床疗效。Objective To analyze the effect of noninvasive mechanical ventilation on the levels of serum BNP and ET-1 in patients with chronic pulmonary heart disease complicated with respiratory failure. Methods Eighty patients with chronic pulmonary heart disease complicated with respiratory failure were collected and were randomly divided into the experimental group( n = 40) and the control group( n = 40). The control group was given conventional treatment and the experimental group was treated with additional noninvasive mechanical ventilation. The clinical curative rate,blood gas analysis and BNP and serum ET-1 levels were compared between the two groups 72 hours after the treatment. Results The clinical symptoms,signs and blood gas analysis results improved significantly in the experimental group 72 hours after the treatment,among which Sa O2,Pa O2 significantly increased while Pa CO2,HR and RR decreased significantly( P < 0. 05). BNP and ET-1 levels of the experimental group decreased with the improvement of symptoms of hypoxia and carbon dioxide retention( P < 0. 01,P < 0. 05),which was significantly better than the control group. BNP and ET-1 levels were positively correlated. BNP and ET-1 and partial pressure of oxygen were negatively correlated. Pressure was positively correlated with carbon dioxide. Conclusion Noninvasive mechanical ventilation can improve ventilation function in patients with chronic pulmonary heart disease complicated with respiratory failure,reduce the serum BNP and ET-1 levels and improve the clinical efficacy.

关 键 词：无创机械通气 慢性肺心病 呼吸衰竭 脑利钠肽 内皮素-1 

分 类 号：R563.8[医药卫生—呼吸系统]