无创正压通气对急性左心衰患者生物标志物的影响及其临床意义  

Study on the clinical significance of non-invasive positive pressure ventilation on biomarkers in patients with acute heart failure

作　　者：可爱华 叶青[1] 曹霞 KE Ai-hua;YE Qing;CAO Xia(Department of Pneumology, Beijing Haidian Hospital (Haidian Hospital of Beijing University Third Hospital ) , Beijing 100086, China)

机构地区：[1]北京市海淀医院(北京大学第三医院海淀院区)呼吸科,北京100086

出　　处：《临床和实验医学杂志》2019年第1期88-91,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金面上项目(编号:7102145)

摘　　要：目的探讨无创正压通气对急性左心衰患者生物标志物的影响及其临床意义。方法回顾性分析北京市海淀医院就诊的急性左心衰患者62例,按照治疗方法分为对照组(n=32)和观察组(n=30)。对照组患者给予常规治疗,观察组患者则在常规治疗的基础上加用无创呼吸机辅助治疗。比较两组患者入院即刻、入院6 h的临床指标(包括收缩压、心率、呼吸频率、动脉氧分压)变化,以及入院即刻、6 h、24 h外周血心衰生物标志物(包括B型脑钠肽、高敏C反应蛋白、可溶性ST2、半乳糖凝集素3)的水平变化。结果两组患者6 h、24 h的B型脑钠肽及可溶性ST2水平均逐渐下降,但观察组下降更明显(P <0. 05),高敏C反应蛋白及半乳糖凝集素3则较入院时无明显变化(P> 0. 05)。结论无创正压通气可以快速改善急性左心衰患者的临床指标,同时降低外周血B型脑钠肽、可溶性ST2水平,有利于急性左心衰的好转。Objective To explorte the influence and clinical significance of non-invasive positive pressure ventilation on biomarkers in patients with acute heart failure.Methods 62 patients with acute left heart failure were divided into control group(n=32)and observation group(n=30)in this hospital.Patients in control group were given with conventional therapy,and patients in observation group were given with non-invasive positive pressure ventilation on the basis of that in control group.Clinical parameters including blood pressure,heart rate,respiratory rate and arterial oxygen pressure were recorded instantly and 6 hours after admission.Circulating biomarkers including B-type brain natriuretic peptide,soluble ST2,galectin-3 and high sensitivity C-reactive protein were determined instantly at admission,6 hours and 24 hours after admission for each individual.Results Levels of B-type natriuretic peptide,soluble ST2 in these two groups were dropped significantly,but further dropping in observation group(P<0.05).The difference in levels of galectin-3 and high sensitivity C-reactive protein was not significant in either group and admission instantly(P>0.05).Conclusion Non-invasive positive pressure ventilation can quickly improve the clinical parameters in patients with acute left heart failure,and reduce B type natriuretic peptide and soluble ST2 simultaneously.Thus it will help to relieve the status of acute left heart failure.

关 键 词：急性左心衰 无创正压通气 B型脑钠肽 可溶性ST2 血浆半乳糖凝集素3 

分 类 号：R541.6[医药卫生—心血管疾病]