无创正压通气治疗老年急性左心衰竭的效果及对生物标志物的影响  

Efficacy and biomarker levels of NPPV in the treatment of elderly patients with acute left heart failure based on changes in cardiac function

作　　者：林基表 刘国兴 张忠金 叶太明 Lin Jibiao;Liu Guoxing;Zhang Zhongjin;Ye Taiming(Department of Cardiology,Ningde Hospital Affiliated to Ningde Normal University,Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院心血管内科,宁德352100

出　　处：《中国临床保健杂志》2023年第6期814-818,共5页Chinese Journal of Clinical Healthcare

基　　金：福建省宁德市厦门大学产学研合作项目(2020C001)。

摘　　要：目的 探讨老年急性左心衰竭(ALHF)患者采用无创正压通气(NPPV)治疗对其心功能及生物标志物的影响。方法 选取2020年1月至2021年12月宁德师范学院附属宁德市医院收治的老年ALHF患者202例,按照随机数字表法分为对照组和观察组,各101例。对照组患者给予标准抗心力衰竭方案治疗,观察组患者在对照组的基础上联合NPPV治疗,2组均治疗10 d。比较2组患者治疗后的临床疗效,治疗前后的心率变异性、心力衰竭标志物、心功能指标以及治疗期间的不良反应发生情况。结果 治疗后,观察组患者的临床总有效率比对照组高;与治疗前比较,治疗后2组患者窦性心搏期间均值与标准差和均方根、左心室射血分数、左心室短轴缩短率及血清N末端脑钠肽前体、可溶性ST2水平均降低,观察组低于对照组;左心室舒张末期内径均缩短,观察组短于对照组,差异均有统计学意义(P值均<0.05);2组患者治疗前后及组间血清半乳糖凝集素-3(Gal-3)水平和治疗期间的不良反应总发生率比较,差异均无统计学意义(P值均<0.05)。结论 NPPV应用于老年ALHF患者可以改善心力衰竭的生物标志物水平,促进心功能恢复,提升临床治疗效果,且无明显不良反应。Objective To investigate the effect of non-invasive positive pressure ventilation(NPPV)on the cardiac function and biomarker levels in elderly patients with acute left heart failure(ALHF).Methods A total of 202 elderly patients with ALHF admitted to Ningde Hospital Affiliated to Ningde Normal University from January,2020 to December,2021 were selected and divided into control group and observation group according to the random number table method,with 101 cases in each group.The patients in the control group were treated with standard anti-heart failure regimen,and the patients in the observation group were treated with NPPV on the basis of the control group,and both groups were treated for 10 day.The clinical efficacy after treatment,heart rate variability indexes,heart failure markers,cardiac function indexes before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups of patients.Results After treatment,the clinical total effective rate of the observation group was higher than that of the control group;Compared with before treatment,the mean value of sinus beat period,the standard deviation of sinus beat period,the root mean square of sinus beat period,left ventricular ejection fraction,left ventricular fraction shortening,N-terminal pro brain natri-uretic peptide and soluble ST2 decreased,and the observation group was lower than the control group;the left ventricular end-diastolic diameter shortened,and the observation group was shorter than the control group,and the differences were statistically significant(all P<0.05);There were no significant differences in serum Galectin-3 levels before and after treatment and the total incidence of adverse reactions during treatment between the two groups(all P>0.05).Conclusions The application of NPPV in elderly ALHF patients can improve the levels of various biomarkers,promote the recovery of cardiac function,and improve the clinical treatment effect without obvious adverse reactions.

关 键 词：心力衰竭 生物学标记 正压呼吸 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]