家庭无创通气对慢性肺心病肺动脉高压的影响

Effect of noninvasive mechanical ventilation at home on pulmonary arterial hypertension in patients with chronic cor pulmonale

目的探讨家庭无创机械通气对慢性肺源性心脏病(简称慢性肺心病)肺动脉高压的影响。方法慢性肺源性心脏病代偿期患者60例,随机分成治疗组30例(家庭无创机械通气联合常规治疗12周)和常规组30例(常规治疗12周),测定治疗前后患者血浆ET-1、NO水平、血气变化及肺动脉压力等。结果①治疗组患者血浆NO水平明显升高(P<0.05)、血浆ET-1水平明显下降(P<0.05)。②治疗组肺动脉压、PaCO_2明显下降(P<0.05),PaO_2明显升高(P<0.05)。③血浆NO水平变化与肺动脉压、PaCO_2呈负相关,与PaO_2呈正相关;血浆ET-1与肺动脉压、PaCO_2呈正相关,与PaO_2呈负相关。结论家庭无创机械通气治疗是慢性肺心病失代偿期患者肺动脉高压的重要治疗措施。

Objective To investigate the effect of noninvasive mechanical ventilation at home on pulmonary arterial hypertension in the patients with chronic cor pulmonale. Methods Sixty patients were enrolled in this study and divided into two groups, treatment group （30 cases） and control group （30 cases）. All the patients received conventional therapy, and patients in treatment group received noninvasive mechanical ventilation at home additionally. Pulmonary arterial pressure, blood gas analysis and the lab markers such as ET-1 ,NO were observed carefully. Results Noninvasive mechanical ventilation at home significantly decreased the plasma concentration of ET-1, pulmonary hypertension,pace, increased the plasma concentration of NO and P02. The plasma concertration of NO had negative correlation with pulmonary hypertension and PaCO2 had positive correlation with PaO2. The plasma concentration of ET-1 had positive correlation with pulmonary hypertension and PaCO2, had negative correlation with PaO2. Conclusion Noninvasive mechanical ventilation at home is a better method to treat pulmonary hypertension.