D-二聚体,高敏C反应蛋白和脑钠肽对COPD合并呼吸衰竭预后的影响

Prognosis of D-Dimer,High-Sensitive C-Reactive Protein and Brain Natriuretic Peptide in COPD Patients with Respiratory Failure

目的:观察D-二聚体,高敏C反应蛋白和脑钠肽对COPD合并呼吸衰竭预后的影响。方法:选取2009年3月至2011年3月本院呼吸科的COPD合并Ⅱ型呼吸衰竭患者80例,随机分为观察组和对照组,各40例。对照组予以常规方法治疗,观察组在对照组的基础上予以BiPAP呼吸机行无创通气治疗。观察两组的血气分析,D-二聚体,高敏C反应蛋白(hs-CRP)和脑钠肽(BNP)。结果:治疗后两组的PaO2和pH水平较治疗前明显的升高,而PaCO2,BNP,hs-CRP和D-二聚体较治疗前明显降低,观察组较对照组升高或降低更为明显(P<0.01)。结论:BiPAP呼吸机行无创通气治疗COPD合并呼吸衰竭治疗效果显著,而检测患者血清中BNP,hs-CRP和D-二聚体浓度的变化可用于预后评价。

Objective： To observe the prognosis of D-dimer,high-sensitivity C-reactive protein（hs-CRP） and brain natriuretic peptide（BNP） in COPD patients with respiratory failure.Methods： 80 COPD patients with type II respiratory failure,from March 2009 to March 2011,were randomly divided into the observation group and the control group,each of which had 40 cases.The control group received conventional therapy,however,the observation group were treated with free invasive ventilation（BiPAP ventilator） in the basis of the control group.The blood gas analysis,D-dimer,high-sensitivity C-reactive protein（hs-CRP）,and brain natriuretic peptide（BNP） were observed.Results： After treatment,the levels of PaO2 and pH increased significantly than those before treatment,while the levels of PaCO2,BNP hs-CRP and D-dimer was significantly lower compared with those before treatment,the observation group increased or decreased more significantly compared with the control group（P0.01）.Conclusion： The non-invasive ventilation with BiPAP was obvious in COPD patients with respiratory failure,the changes of serum BNP,hs-CRP and D-dimer can be used for the evaluation of prognosis.