重组人脑利钠肽治疗高原肺水肿的动脉血气观察

Recombinant human brain natriuretic peptide improves arterial blood gas parameters in patients with high altitude pulmonary edema

目的:探索重组人脑利钠肽(rhBNP)治疗高原肺水肿患者的动脉血气变化情况。方法:收集我院自2007年3月～2008年11月收治的高原肺水肿118例,随机分为普通治疗组和重组人脑利钠肽组。两组入院后都给予吸氧、利尿、镇静、扩张支气管、减轻心脏负荷等处理,此外,对重组人脑利钠肽组同时给予重组人脑利钠肽治疗。动态监测两组在治疗前和治疗后24、48、72 h动脉血气的变化,比较两组动脉血气变化情况。结果:重组人脑利钠肽组动脉血氧分压(PaO2)和动脉血氧饱和度(SaO2)较普通治疗组显著升高,二氧化碳分压(PaCO2)较普通治疗组显著降低,总二氧化碳(TCO2)则无明显变化。结论:重组人脑利钠肽可能成为治疗高原肺水肿的一种新药,值得深入研究。

Objective：To explore the effects of reconbinant human brain natriuretie peptide （rhBNP） on arterial blood gases in patients with high ＇altitude pulmonary edema （HAPE）. Methods：118 patients with HAPE treated in our hospital from March ,2007 to November,2008 were included in this study. They were randomly divided into conventional group and rhBNP group. All patients received supplemental oxygen ,diuretics ,sedatives,and bronchial dilators. In addition,those in rhBNP group ret.eived rhBNP therapy with a loading dose of 1.5 g/kg and a nmintenanee dose of 0.0075 g/（kg·min） for 24 hours. PaO2 ,SaO2 .PaCO2 and total earbon dioxide （TCO2 ） were measured in all patients before and 24,48,72 hours after treatment. Resulls：PaO2 and SaO2 increased significmltly in rhBNP/group than those in conventional group. Moreover,PaCO2 reduced nmrkedly in rhBNP group than that in conventional group,but TCO2 did not change significantly. Conclusion：RhBNP may be a new therapeutic agent for HAPE.