无创正压通气联合纳洛酮对肺心病急性加重期患者hs-CRP、NT-proBNP和ET-1的影响

Effect of noninvasive BiPAP combined with naloxone on plasma hs-CRP, NT-proBNP and ET-1 levels in patients with acute exacerbation of pulmonary heart disease

目的 探讨无创正压通气联合纳洛酮对慢性肺源性心脏病（肺心病）急性加重期患者超敏C-反应蛋白（hs-CRP）、N-末端B型脑钠肽前体（NT-proBNP）和内皮素-1（ET-1）的影响.方法 将106例肺心病急性加重期患者随机分为两组,每组53例.对照组采用常规治疗,观察组在常规治疗的基础上加用无创正压通气联合纳洛酮.治疗10 d后观察疗效.测定治疗前后患者血浆hs-CRP、NT-proBNP和ET-1.结果 两组患者治疗后平均肺动脉压（MPAP）均明显下降,并且观察组比对照组下降更明显（P＜0.05）.两组在治疗后患者血浆hs-CRP、NT-proBNP和ET-1均有明显下降,与对照组比较,观察组治疗后下降更明显（P＜0.05）.结论 无创正压通气联合纳洛酮可以明显减少肺心病急性加重期患者hs-CRP、NT-proBNP和ET-1的表达.

Objective To investigate the effect of noninvasive BiPAP combined with naloxone on plasma high sensitivity C-reactive protein（hs-CRP）,N-terminal pro-B-type brain natriuretic peptide（NT-proBNP） and endothelin（ET-1） levels in patients with acute exacerbation of pulmonary heart disease.Methods One hundred and six patients with severe bronchial asthma were randomly divided into two groups,the observation group and the control group,with 53 cases in each group.Control group was given conventional treatment,while in observation group,based on conventional treatment,noninvasive positive pressure ventilation combined with naloxone was given.The effects were observed after 10 days of treatment.The mean pulmonary arterial pressure（MPAP）,plasma hs-CRP,NT-proBNP and ET-1 were detected before and after treatment.Results MPAP in both groups decreased obviously after treatment,and MPAP of observation group was lower than that of the control group （P ＜ 0.05）.Plasma hs-CRP,NT-proBNP and ET-1 levels significantly reduced in both groups after treatment,the observation group decreased more significantly,compared with the control group after treatment （P ＜ 0.05）.Conclusions Noninvasive BiPAP combined with naloxone can decrease the expression of plasma hs-CRP,NT-proBNP and ET-1 levels in patients with acute exacerbation of pulpmonary heart disease.