NT-proBNP评估无创正压通气治疗急性左心衰的疗效  

Evaluation value of NT-proBNP for therapeutic effect of noninvasive bilevel positive airway pressure ventilation in aged patients with acute left heart failure

作　　者：周哲慧[1] 宋雅君[1] 刘沁[1] 庄丽英[1] 李藜[1] 

机构地区：[1]上海市黄浦区中心医院老年病科,上海200002

出　　处：《心血管康复医学杂志》2016年第2期167-171,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：上海市黄浦区卫生系统医学重点专科项目~~

摘　　要：目的:探讨双水平无创正压通气治疗(BiPAP)对老年急性左心衰患者的疗效及N末端脑钠肽原(NTproBNP)对其疗效的评估价值。方法:选择于我院就诊的老年急性心衰患者80例,依据随机数字表均分为常规治疗组和BiPAP组(在常规治疗组基础上接受无创呼吸机通气治疗,采用BiPAP通气模式)。比较两组患者治疗前后NT-proBNP水平、心率(HR)、收缩压(SBP)、舒张压(DBP)、呼吸频率(RR)及动脉血气分析的变化。应用直线相关分析评估血浆NT-proBNP水平与以上指标的相关性。结果:治疗前两组各指标比较无显著差异(P均>0.05)。与治疗前比较,治疗后4h两组HR、SBP、DBP、RR和NT-proBNP水平均显著降低,动脉血氧分压(PaO2)显著升高(P<0.05或<0.01),且与常规治疗组比较,BiPAP组PaO2[(75.13±19.93)mmHg比(85.88±18.47)mmHg]显著升高,NT-proBNP水平[(3786.71±1270.38)pg/ml比(2658.65±1222.08)pg/ml]显著降低(P均<0.05)。直线相关分析显示NT-proBNP水平与HR(r=0.383)、SBP(r=0.360)、RR(r=0.345)和PaCO2(r=0.413)呈显著正相关,与PaO2(r=-0.471)呈显著负相关,P<0.05或<0.01。结论:双水平无创正压通气治疗可提高老年急性心衰患者的临床疗效,且N末端脑钠肽原水平有助于其疗效的评估。Objective：To explore therapeutic effect of noninvasive bilevel positive airway pressure ventilation（BiPAP）on aged patients with acute left heart failure（ALHF）and evaluation value of NT-proBNP for therapeutic effect in these patients.Methods：A total of 80 aged ALHF patients treated in our hospital were selected.According to random number table,they were equally divided into routine treatment group and BiPAP group（received BiPAP therapy based on routine treatment group）.NT-proBNP level,heart rate（HR）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,respiratory rate（RR）and arterial blood gas were compared between two groups before and after treatment.Linear correlation analysis was used to evaluate the correlation among plasma NT-proBNP level and above indexes.Results：There were no significant difference in all indexes between two groups before treatment（P〉0.05all）.Compared with before treatment,on 4hafter treatment,there were significant reductions in levels of HR,SBP,DBP,RR and NT-proBNP,and significant rise in partial pressure of oxygen in artery（PaO2）in both groups（P〈0.05or〈0.01）,and compared with routine treatment group,there was significant rise in PaO2[（75.13±19.93）mmHg vs.（85.88±18.47）mmHg],and significant reduction in NT-proBNP level[（3786.71±1270.38）pg/ml vs.（2658.65±1222.08）pg/ml]in BiPAP group（P〈0.05both）.Linear correlation analysis indicated that NT-proBNP level was significant positively correlated with HR（r=0.383）,SBP（r=0.360）,RR（r=0.345）and PaCO2（r=0.413）,and significant inversely correlated with PaO2（r=-0.471）,P〈0.05or〈0.01.Conclusion：BiPAP ventilation therapy can improve clinical therapeutic effect in aged ALHF patients,and NT-proBNP is help to evaluating its therapeutic effects.

关 键 词：心力衰竭 连续气道正压通气 利钠肽 脑 

分 类 号：R541.61[医药卫生—心血管疾病]