摘要
【目的】探讨无创正压通气对慢性阻塞性肺病（COPD）急性加重并严重呼吸衰竭患者血浆脑钠肽（BNP）含量的影响。【方法】COPD急性加重并严重呼吸衰竭患者64例，随机分成常规治疗组（n=32）和无创通气组（n=32），常规治疗组给予静脉滴注呼吸兴奋剂、降肺动脉压、强心、利尿剂等药物并加用面罩给氧治疗。无创通气治疗组在常规内科治疗同时加用无创正压通气治疗，观察治疗3天后两组患者心率（HR）、呼吸频率（RR）、血压、动脉血氧饱和度（SaO2）、血气分析及血浆BNP的变化。【结果】治疗3d后，与常规治疗组比较，无创通气治疗组患者临床症状与体征的改善明显，血气分析SaO2、动脉氧分压（PaO2）明显升高、动脉二氧化碳分压（PaCO2）、HR、RR、MAP显著下降，两组差异有显著性（P〈0．05）。治疗3天后无创通气组血浆BNP较常规治疗组下降显著，差异有显著性（P〈0．05）。【结论】无创正压通气降低慢性COPD急性加重并严重呼吸衰竭患者血浆BNP的水平，其对患者神经内分泌的影响可能是改善通气功能机制之一。
[Objective] To investigate the curative effects of non-invasive positive pressure ventilation on chronic obstructive pulmonary disease（COPD）complicated with severe respiratory failure and the influence on plasma brain natriuretic peptide（BNP）. [Methods] Sixty four patients with COPD complicated with severe re- spiratory failure were randomly divided into non-invasive ventilation treatment group and routine therapy group. Patients in the routine therapy group（ n = 32） were treated by respiratory stimulant, reduction of pulmonary artery pressure, cardiotonic, diuretics and combined with nasal pipe with oxygen, while patients in the non-invasive ventilation treatment group（ n = 32） were treated by routine therapy combined with non-invasive positive pressure ventilation. Heart rate, respiratory rate, blood pressure, pulse, saturation of blood oxygen, blood gas analysis and clinical signs were observed after three days of treatment. The concentration of plasma BNP was measured at the beginning and three days later. [Results] The clinical symptoms and signs improved significantly. SaO2 and PaO2 elevated and PaCO2, RR and HR reduced significantly（ P 〈0.05） in the non-in- vasive ventilation group than those in the routine therapy group. The plasma level of BNP was significantly decreased after treatment in both groups, especially in the treatment group（ P d0.05）. [Conclusion] Non-invasire positive pressure ventilation can improve hypoxemia and CO2 retention and decrease the level of BNP in patients with COPD complicated with severe respiratory failure. The influence of non-invasive ventilation on nervous endocrine may be one of the important mechanisms for ventilation function improvement.
出处
《医学临床研究》
CAS
2010年第3期411-413,共3页
Journal of Clinical Research
关键词
肺疾病
阻塞性/并发症
呼吸功能不全/血液
利钠肽
脑/血液
正压呼吸
lung diseases, obstructive/CO2 respiratory insufficieney/BL
natriuretic peptide, brain positive-pressure respiration
