B型脑钠肽对慢性阻塞性肺病急性加重伴Ⅱ型呼吸衰竭患者机械通气的影响  

The impact of B-type brain natriuretic peptide on mechanical ventilation in patients who suffered from acute exacerbations of chronic obstructive pulmonary disease with type Ⅱ respiratory failure

作　　者：董晓辉[1] 何海云[1] 

机构地区：[1]浙江省湖州市中心医院内科,浙江湖州313000

出　　处：《中国现代医生》2016年第30期33-35,38,共4页China Modern Doctor

基　　金：浙江省医药卫生平台计划项目(骨干人才)(2014RCA029)

摘　　要：目的 探讨BNP对慢性阻塞性肺病急性加重合并Ⅱ型呼吸衰竭患者机械通气的影响。方法 入选2013年1-12月在我院呼吸科住院的116例慢性阻塞性肺病急性加重伴Ⅱ型呼吸衰竭患者,依据入院24 h内血BNP结果,分为对照组（BNP〈300 ng/mL）67例与心衰组（BNP≥300 ng/mL）49例。收集入选者的基本情况、疗效、机械通气、气管插管情况等资料,分析两组的机械通气率、气管插管率的差异。结果 对照组与心衰组的机械通气的使用率分别为31.3%、69.4%,气管插管率分别为6.0%、28.6%,两组比较差异均有统计学意义（P〈0.05）;入院时动脉血气分析中对照组与心衰组PaCO_2分别为（64.1±18.2）mmHg、（75.3±21.0）mmHg,pH值分别为（7.334±0.078）、（7.298±0.098）,两组比较差异均有统计学意义（P〈0.05）。结论 合并心衰的慢性阻塞性肺病急性加重伴Ⅱ型呼吸衰竭患者机械通气率及气管插管发生率高,提示BNP检测有助于病情严重程度评估。Objective To explore the impact of B-type brain natriuretic peptide on mechanical ventilation in patients who suffered from acute exacerbations of chronic obstructive pulmonary disease with type 11 respiratory failure. Methods A total of 116 patients who were admitted to respiratory department in our hospital for acute exacerbation of chronic obstructive pulmonary disease with type I1 respiratory failure from Jan to Dec 2013 were enrolled in this study. The patients were divided into the control group （BNP〈300 ng/mL, 67 cases） and heart failure group （BNP≥300 ng/mL, 49 cases）, according to the results of blood BNP. The basic situation of patients, efficacy, mechanical ventilation, intubation were collected. Mechanical ventilation usage rates, intubation rates and the rate of improvement were analyzed. Results Between control group and heart failure group, the utilization of mechanical ventilation were 31.3% and 69.4%, the intubation rates were 6.0% and 28.6%, respectively.The differences of two groups were significant（P〈0.05）. Arterial blood gas analysis on admission were carried out in the two groups. Compared with the control group, heart failure group had significantly higher PaCO2 [（75.3±21.0） mmHg vs （64.1±18.2 mmHg）], and lower pH values [（7.298±0.098） vs （7.334±0.078）, P〈0.05]. Conclusion Patients combined with heart failure who are suffering from acute exacerbations of chronic obstructive pulmonary disease with type Ⅱ respiratory failure have higherly intubation rates and mechanical ventilation rates, it suggests that thyroid function tests may help to assess the severity.

关 键 词：B型脑钠肽 慢性阻塞性肺疾病 呼吸衰竭 机械通气 

分 类 号：R563.9[医药卫生—呼吸系统]