无创呼吸机对肺源性心脏病合并呼吸衰竭患者缺氧状态的改善及对脑钠肽和内皮素-1的影响  

The effect of noninvasive ventilation on the improvement of hypoxia in patients with pulmonary heart disease complicated with respiratory failure and its impact on BNP and ET-1

作　　者：陈天明[1] 卢青[2] 杨锁平[1] 李任翔[1] 余国辉[1] 

机构地区：[1]湖北省荆门市第一人民医院呼吸内科,448000 [2]荆楚理工学院医学院内科教研室

出　　处：《山西医药杂志》2017年第13期1544-1547,共4页Shanxi Medical Journal

摘　　要：目的探讨无创呼吸机对肺源性心脏病合并呼吸衰竭患者缺氧状态的改善效果及对脑利钠肽(BNP)和内皮素(ET-1)的影响。方法选取2015年1月至2016年12月收治的92例肺源性心脏病合并呼吸衰竭的患者,按随机数字表法分为观察组和对照组各46例。对照组按照诊疗常规进行治疗,观察组在诊疗常规的基础上,加用无创呼吸机辅助通气。对比2组患者治疗前和治疗后72h的心率、呼吸频率、血压以及动脉血气分析结果;对比2组患者治疗前后BNP和ET-1的变化。结果观察组治疗后的心率为(78±9)次/min,呼吸频率为(17±4)次/min,平均动脉压为(82±5)mmHg,均显著低于对照组(均P<0.05);观察组治疗后的氧分压为(98±8)mmHg,血氧饱和度为(92±7)%,均显著高于对照组(均P<0.05);观察组治疗后的二氧化碳分压为(44.0±1.6)mmHg,显著低于对照组(P<0.05);观察组治疗后的BNP为(108±31)pg/mL,ET-1为(44±12)pg/mL,均显著低于对照组(均P<0.05)。结论无创呼吸机可显著改善肺源性心脏病合并呼吸衰竭患者的缺氧状态,同时降低BNP和ET-1的浓度,可进一步提高肺源性心脏病合并呼吸衰竭的治疗效果。Objective To discuss the effect of noninvasive ventilation on the improvement of hypoxia in pa- tients with pulmonary heart disease complicated with respiratory failure and its impact on brain natriuretic peptide （BNP） and endothelin （ET-1）. Methods Ninty-two patients with pulmonary heart disease complicated with re- spiratory failure were selected from January 2015 to December 2016 and were randomly divided into observation group and control group, 46 cases in each group. The control group was treated with routine treatment. On the basis of routine treatment, the observation group was treated with noninvasive mechanical ventilation. The heart rate, respiratory rate, blood pressure and blood gas analysis were compared between the two groups before and 72 hours after treatment. The changes of BNP and ET-1 were compared between the two groups before and after treatment. Results After treatment, the heart rate of the observation group was （78±9）/rain, respiratory fre- quency was （17±4）/min, mean arterial pressure was （82±5）mmHg, which were significantly lower than those in the control group （P〈0.05）. After treatment, the oxygen partial pressure of the observation group was （98± 8）mmHg, the blood oxygen saturation were （92±7）%, which were significantly higher than those of the control group （P〈0.05）. After treatment, the carbon dioxide partial pressure of the observation group was （44.0 ± 1.6） mmHg, which was significantly lower than that of the control group （ P 〈0.05）. After treatment, the BNP of the observation group was （108±31）pg/mL, ET-1 was （44 ± 12）pg/mL, which were significantly lower than those in the control group （ P 〈0. 05）. Conclusion Noninvasive ventilation can significantly improve the hypoxic state of patients with pulmonary heart disease complicated with respiratory failure, reduce the level of BNP and ET-1, and further improve the clinical efficacy.

关 键 词：肺心病 无创呼吸机 呼吸功能不全 利钠肽 脑 内皮素-1 

分 类 号：R541.5[医药卫生—心血管疾病] R563.8[医药卫生—内科学]