摘要
目的探究BiPAP无创正压通气联合贝那普利对急性心力衰竭患者的影响。方法回顾性选取2020年4月-2023年4月上海交通大学医学院附属瑞金医院无锡分院及上海交通大学医学院附属瑞金医院收治的106例急性心力衰竭患者,根据治疗方案将其分为试验组(n=53)和对照组(n=53)。对照组患者接受盐酸贝那普利片治疗,试验组患者在对照组的基础上接受BiPAP无创正压通气治疗,均连续治疗7 d。比较两组患者治疗前后血气分析指标〔动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、氧合指数(OI)〕、肺功能指标〔肺顺应性(CL)、气道阻力(Raw)、呼气流量峰值(PEF)〕、心功能指标〔N末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)、左心室射血分数(LVEF)〕、血浆内分泌激素(血管紧张素Ⅱ、醛固酮、肾素活性)水平及治疗期间心脏不良事件发生率。结果治疗后,两组SaO_(2)、PaO_(2)、OI分别高于本组治疗前,且试验组SaO_(2)、PaO_(2)、OI高于对照组(P<0.05);治疗后,两组CL、PEF分别高于本组治疗前,Raw分别低于本组治疗前,且试验组CL、PEF高于对照组,Raw低于对照组(P<0.05);治疗后,两组NT-proBNP、cTnI分别低于本组治疗前,LVEF分别高于本组治疗前,且试验组NTproBNP、cTnI低于对照组,LVEF高于对照组(P<0.05);治疗后,两组血浆血管紧张素Ⅱ、醛固酮、肾素活性分别低于本组治疗前,且试验组血浆血管紧张素Ⅱ、醛固酮、肾素活性低于对照组(P<0.05)。试验组心脏不良事件总发生率低于对照组(P<0.05)。结论BiPAP无创正压通气联合贝那普利能有效改善急性心力衰竭患者的血气分析指标、心肺功能和内分泌激素水平,减少心脏不良事件的发生。
Objective To explore the effects of BiPAP non-invasive positive pressure ventilation combined with benazepril on patients with acute heart failure.Methods A retrospective study was conducted on 106 patients with acute heart failure admitted to Wuxi Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2020 to April 2023.Patients were divided into experimental group(n=53)and control group(n=53)based on treatment regimens.The control group received benazepril hydrochloride tablets,while the experimental group received additional BiPAP non-invasive positive pressure ventilation on the basis of the control group,continuously for 7 days.The blood gas analysis indexes[arterial oxygen saturation(SaO_(2)),partial pressure of oxygen in arterial blood(PaO_(2)),oxygenation index(OI)],pulmonary function indexes[lung compliance(CL),airway resistance(Raw),peak expiratory flow(PEF)],cardiac function indexes[N-terminal pro-brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),left ventricular ejection fraction(LVEF)],plasma endocrine hormone(angiotensinⅡ,aldosterone,renin activity)before and after treatment and the incidence of cardiac adverse events during the treatment were compared between the two groups.Results After treatment,the SaO_(2),PaO_(2),OI in the two groups were higher than those before treatment,respectively,and the SaO_(2),PaO_(2),OI in experimental group were higher than those in control group(P<0.05).After treatment,the CL,PEF in the two groups were higher than those before treatment,Raw was lower than that before treatment,respectively,and the CL,PEF in experimental group were higher than those in control group,Raw was lower than that in control group(P<0.05).After treatment,the NT-proBNP,cTnI in the two groups were lower higher than those before treatment,LVEF was higher than that before treatment,respectively,and the NT-proBNP,cTnI in experimental group were lower than those in control group,LVEF was higher than that in control group(P<0.05).After treatment,the plasma angiotensinⅡ,aldosterone,renin activity in the two groups were lower than those before treatment,respectively,and the plasma angiotensinⅡ,aldosterone,renin activity in experimental group were lower than those in control group(P<0.05).The overall incidence of cardiac adverse events in experimental group was lower than that in control group(P<0.05).Conclusion BiPAP non-invasive positive pressure ventilation combined with benazepril can effectively improve blood gas analysis indexes,cardiopulmonary function and endocrine hormone levels in patients with acute heart failure,and reduce the occurrence of adverse cardiac events.
作者
白志勇
黄亚国
周与华
BAI Zhiyong;HUANG Yaguo;ZHOU Yuhua(Department of Emergency Medicine,Wuxi Branch of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Wuxi 214111,China;Department of Emergency Medicine,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China)
出处
《实用心脑肺血管病杂志》
2024年第8期118-122,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
江苏省自然科学基金资助项目(BK20211167)。
关键词
心力衰竭
连续气道正压通气
贝那普利
血气分析
Heart failure
Continuous positive airway pressure
Benazepril
Blood gas analysis
