BiPAP治疗急性左心衰竭对内皮素-1与肺动脉压的影响

The efffect of BiPAP on endothelin-1 and pulmonary artery pressure in patients with acute left ventricular failure

目的:观察BiPAP治疗急性左心衰时是否对内皮素-1和肺动脉影响。方法:60例急性左心衰患者,随机分为治疗组和对照组,每组30例,治疗组除药物治疗外入院后立即使用BiPAP治疗,对照组除药物外采用鼻导管或面罩吸氧,入院后0 h、12 h、24 h分别监测心率、呼吸频率、肺动脉压、内皮素-1变化。结果:①经治疗12 h后治疗组(30/30)心力衰竭症状缓解,对照组(25/30)心衰症状部分缓解,两组间比较差异有统计学意义(P<0.05)。②治疗组24 h后心率、肺动脉压、内皮素-1显著低于对照组,两组间比较差异有统计学意义(P<0.05)。结论:BiPAP能迅速缓解急性左心衰患者临床症状,能降低内皮素-1及肺动脉压水平。

Objective To observe the influence of bi -level positive airway pressure（BiPAP） on endothelin -1 （ET- 1 ） and pulmona- ry artery pressure in patients with acute left ventrieular failure. Method 60 patients with acute left ventrieular failure were randomly divid- ed into control group （30 cases）and BiPAP group （30 cases）. The control group received the conventional drug therapy, and the BiPAP group was treated with BiPAP in addition. The changes of heart rate （ HR）, respiratory rate （RR） , pulmonary artery pressure, and ET- 1 in two groups were observed in 0 h^12 h,24 h after hospitalized. Results 1 ,Symptom of all patients in BiPAP group（30/30） were alleviated after 12h by treated, but symptom of 25 patients （25/30） were alleviated after 12 h by treated in control group, it was significant difference by statistical test（ P 〈 0. 05 ）. 2 ,Compared with control group, BiPAP group had a more significant decrease of HR,PAP,ET - 1 （ P 〈 0. 05 ） . Conclusion Clinical symptoms are rapidly alleviated in patients with acute left ventricular failure by BiPAP, and BiPAP can reduce ET- 1 and PAP level.