| 摘要: |
| 目的 探讨无创正压通气对慢性阻塞性肺疾病（COPD）合并肺源性心脏病的疗效和对患者血浆C 反应蛋白（CRP）和脑钠素（BNP）水平的影响。方法 将2012 年1 月到2014 年1月收治的120 例COPD 急性加重期合并肺源性心脏病患者随机分为观察组（60 例）和对照组（60 例），对照组给予常规治疗，观察组在此基础上给予无创正压通气治疗。治疗前和治疗3d 后分别进行动脉血气分析，比较患者血pH 值、PaO2、PaCO2和动脉血氧饱和度（SaO2）在治疗前后的改变，并监测治疗前后血浆CRP和BNP 水平的改变。结果 治疗3d 后，两组患者的pH 值、PaO2、SaO2均较治疗前明显升高，PaCO2较治疗前明显降低，而观察组患者治疗后的动态血气分析指标的改善情况明显优于对照组，均有统计学差异（均P＜0.05）。两组患者的血浆CRP 和BNP 水平均较治疗前明显降低，而观察组患者治疗后的血浆CRP 和BNP 水平明显低于对照组，均有统计学差异（均P＜0.05）。结论 无创正压通气治疗COPD 合并肺源性心脏病,能够有效改善血气指标，提高SaO2和PaO2，同时降低血浆CRP 和BNP 的水平，值得在临床推广应用。 |
| 关键词: 无创正压通气 COPD 肺源性心脏病 CRP BNP |
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| Noninvasive positive pressure ventilation in treatment of COPD with pulmonary heart disease and its relation to plasma C-reactiveprotein and brain natriuretic peptide |
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ZHONG Xiaodong, CHEN Xueqing, WANG Chen, LOU Linjuan, FENG Qijia
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Lin'an People's Hospital
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| Abstract: |
| Objective To investigate noninvasive positive pressure ventilation (NPPV) in treatment of chronic obstructive pulmonary disease (COPD) with pulmonary heart disease and its relation of plasma C-reactive protein (CRP) and brain natriuretic peptide(BNP). Methods One hundred and twenty COPD patients with pulmonary heart disease admitted in our hospital from January 2012 to January 2014 were randomly divided into NPPV group (n=60) and control group (n=60). Conventional treatment was given to both groups, while NPPV group received additional noninvasive positive pressure ventilation. The blood gas was analyzed before and 3d after treatment, the pH, arterial oxygen pressure (PaO2), arterial carbon dioxide partial pressure(PaCO2) and arterial oxygen saturation (SaO2) changes were compared before and after treatment in both groups. Plasma CRP and BNP levels were measured before and after treatment. Results Three days after treatment, the pH, PaO2, SO2 were significantly
higher and PaCO2 was significantly lower than before treatment in both groups; the dynamic improvement in blood gas analysis of the NPPV group was significantly better than that of control group (P＜0.05). Compared to pretreatment the plasma CRP and BNP levels were significantly lower after treatment in both groups; the post-treatment BNP plasma CRP levels of NPPV group were significantly lower than those of control group (P＜0.05). Conclusion Noninvasive positive pressure ventilation in treatment of COPD patients with pulmonary heart disease can improve blood indicators, arterial oxygen saturation and blood pressure, which is associated with the decrease of plasma CRP and BNP. |
| Key words: Noninvasive positive pressure ventilation COPD Pulmonary heart disease CRP BNP |
