浅快指数与N端脑钠素前体结合在指导慢性阻塞性肺疾病呼吸衰竭患者呼吸机撤离中的应用价值  

Application value of combination of rapid shallow breathing index and N-terminal-pro-brain natriuretic peptide for ventilator weaning to chronic obstructive pulmonary disease patients with respiratory failure

作　　者：刘领[1] 吴文杰[1] 王艳新 杨霁[1] 熊鑫[1] 赵惠敏[1] 陈杨 薛兵[1] LIU Ling;WU Wen-jie;WANG Yan-xin;YANG Ji;XIONG Xin;ZHAO Hui-min;CHEN Yang;XUE Bin(Department of Respiratory, Chuiyangliu Hospital of Beijing City, Beijing 100022, China)

机构地区：[1]北京市垂杨柳医院呼吸科,北京100022

出　　处：《中国当代医药》2019年第4期51-53,共3页China Modern Medicine

摘　　要：目的探讨浅快指数(RSBI)与N端脑素前体(NT-proBNP)结合对于指导慢性阻塞性肺疾病(COPD)呼吸衰竭机械通气患者呼吸机撤离的价值。方法选择2015年1月1日～2018年1月1日我院收治的78例COPD呼吸衰竭机械通气患者作为研究对象,按呼吸机初次撤离结局分为撤离成功组(61例)及失败组(17例),比较两组达脱机条件时RSBI与NT-proBNP的差异,采用Logistic多元回归分析RSBI、NT-proBNP及两者联合检测对于指导COPD呼吸衰竭患者呼吸机撤离的意义。结果成功组与失败组的RSBI分别为(81.25±10.12)、(110.01±20.13)次/(min·L),成功组与失败组的NT-proBNP分别为(299.26±131.62)、(1286.29±256.16)pg/ml。成功组的RSBI与NTproBNP均低于失败组,差异有统计学意义(P<0.05)。Logistic多元回归分析显示RSBI、NT-proBNP及两者联合对于成功指导呼吸机撤离的相对危险度OR分别为5.236、2.762及6.785(P<0.05),两者联合预测呼吸机撤离价值更高。结论结合分别衡量呼吸肌储备功能的RSBI与评估心功能状态的NT-proBNP可提高COPD呼吸衰竭机械通气患者呼吸机撤离成功率。Objective To assess the value of combination of rapid shallow breathing index (RSBI) and plasma N-terminal -pro-brain natriuretic peptide (NT-proBNP) for ventilator weaning to chronic obstructive pulmonary disease (COPD) patients with respiratory failure. Methods A total of 78 COPD patients with respiratory failure admitted in our hospital from 1 January 2015 to 1 January 2018 were selected as the research objects, they were divided into the success group (61 cases) and the failure group (17 cases) according to the weaning outcome at the first time. The difference of RSBI and plasma NT-proBNP were compared between the two groups when offline conditions were reached. Logistic multiple regression analysis was used to analyze the significance of RSBI, NT-proBNP and their combined detection in guiding ventilator evacuation in COPD patients with respiratory failure. Results The RSBI of the success group and the failure group were (81.25±10.12) times/(min·L),(110.01±20.13) times/(min·L), respectively. The level of NT-proBNP in the success group and the failure group were (299.26±131.62) pg/ml and (1286.29±256.16) pg/ml, respectively. The levels of RSBI and NT-proBNP in the successful group were lower than those in the failure group, and the difference was statistically significant (P<0.05). Logistic multivariate regression analysis showed that the relative risks OR of RSBI, NT-proBNP and their combination for successful ventilator evacuation were 5.236, 2.762 and 6.785, respectively (P<0.05). The combination of the two methods was more valuable in predicting ventilator evacuation. Conclusion Respiratory muscle reserve function measured by RSBI and cardiac function assessed by NT-proBNP can improve the success rate of ventilator evacuation in COPD patients with respiratory failure and mechanical ventilation.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 呼吸机撤离 浅快指数 N端脑钠素前体 

分 类 号：R563.9[医药卫生—呼吸系统]