无创正压通气对AECOPD 伴肺动脉高压患者肺动脉压及血浆脑钠肽水平影响.docVIP

无创正压通气对AECOPD 伴肺动脉高压患者肺动脉压及血浆脑钠肽水平影响 　　doi：10.3969/j.issn.1007-614x.2014.9.59 　　摘 要 目的：探讨无创正压通气（NIPPV）对慢性阻塞性肺疾病急性加重（AECOPD）伴肺动脉高压患者肺动脉压及血浆脑钠肽水平的影响。方法：收治AECOPD伴肺动脉高压患者68例，男37例，女31例，随机分成两组，每组34例。常规治疗组给予积极抗感染、平喘祛痰、强心利尿、皮质激素和气道护理等常规基础治疗。无创正压通气组在常规治疗的基础上给予无创正压通气，分别观察治疗前及治疗24小时后两组血浆BNP含量及肺动脉压的变化。结果：治疗24小时后无创正压通气组血浆B型脑钠肽（BNP）含量及肺动脉压力均明显降低（P0.05）。结论：无创正压通气明显降低AECOPD伴肺动脉高压患者血浆BNP水平及肺动脉压。 　　关键词 肺动脉高压 AECOPD 脑钠肽 无创正压通气 　　Influence of noninvasive positive pressure ventilation on pulmonary artery pressure and plasma level of brain natriuretic peptide in AECOPD patients with pulmonary hypertension 　　Liu Tao，Xu Xiyuan，Wang Ling 　　Respiratory and critical care medicine of The Third Affiliated Hospital of Inner Mongolia Medical University of Baotou City in Inner Mongolia，014010 　　Abstract Objective：To explore the influence of noninvasive positive pressure ventilation on pulmonary artery pressure and plasma level of brain natriuretic peptide in AECOPD patients with pulmonary hypertension.Methods：We selected 68 AECOPD patients with pulmonary hypertension during 2010 January to 2013 May，male 37，female 31，these patients were randomly divided into two groups of 34 people.Routine treatment group was given routine treatment，such as anti infection，antiasthmatic and expectorant，strong heart diuresis，corticosteroids and airway nursing and so on.Noninvasive positive pressure ventilation group received noninvasive positive pressure ventilation on the basis of conventional therapy.The content of BNP and the changes of pulmonary arterial pressure of patients in two groups were observed before and after treatment for 24 hours.Results：After 24 hours of therapy，the content of BNP and the pulmonary arterial pressure of Noninvasive positive pressure ventilation group were decreased significantly（P0.05）.Conclusion：Noninvasive positive pressure ventilation can significantly reduce the content of BNP and the pulmonary arterial pressure in AECOPD patients with pulmonary hypertension. 　　Key words