机械通气对呼吸衰竭并肺动脉高压患者BNP的影响研究

Effect of Mechanical Ventilation on BNP in the Patients with Respiratory Failure and Pulmonary Arterial Hypertension

目的：研究机械通气对重症监护室（ICU）呼吸衰竭并肺动脉高压患者BNP的影响。方法：选择2013年12月-2014年12月在我院ICU接受机械通气治疗的呼吸衰竭并肺动脉高压患者78例，按照随机数字表法分为有创纽与无创组各39例，两纽患者一般资料比较，P〉0．05。两组均给予祛痰平喘、抗感染、皮质激素、强心利尿等常规治疗，有创组在常规治疗基础上行气管插管或气管切开呼吸机辅助呼吸，无创组在常规治疗基础上行面罩呼吸机辅助呼吸，观察两组PaO2、PaCO2、pH值、肺动脉压力、BNP等指标。结果：两组患者治疗后PaO2、PaCO2、pH值、肺动脉压力、BNP均显著优于本组治疗前，P〈0．05；有创组治疗后PaO2、PaCO2、pH值、肺动脉压力、BNP均显著优于无创组治疗后，P〈0．05。结论：有创机械通气与无创机械通气均可改善呼吸衰竭并动脉高压临床症状，降低血浆BNP浓度，但有创机械通气较无创机械通气效果更为显著，临床可以通过监测血浆BNP浓度判断患者病情。

Objective： To the effect of mechanical ventilation on BNP concentration of the patients with respiratory failure and pulmonary hypertension BNP. Methods： 78 patients with respiratory failure and pulmonary hypertension which received ICU mechanical ventilation treatment were selected from December 2013 to December 2014 in our hospital. According to random number table method, all the patients were divided into invasive group and no invasive group, 39 cases each group. The general data between two groups had no statistical difference, P 〉 0.05. All the patients were given eliminating phlegm to smooth wheezing, anti-infection, corticosteroids, strong heart diuresis and other conventional treatment. Based on conventional treatment, the patients in the invasive group uplink were given the ventilator mechanical breathing under endotracheal intubation or tracheostomy, and the patients in no invasive group were given the ventilator mechanical breathing under masks. PaOz, PaCO2, pH value, pulmonary artery pressure, the level of BNP and other indicators was observed and compared between two groups. Results： After treatment, PaO~, PaCO2, pH value, pulmonary artery pressure, the BNP were significantly better than that of the group before treatment, P〈 0.05. After treatment, PaO2, PaCO2, pH value, pulmonary artery pressure, the BNP level in invasive group were significantly better than those of no Invasive group, P〈 0.05. Conclusions： The invasive mechanical ventilation and noninvasive mechanical ventilation can improve the clinical symptoms of respiratory failure and arterial hypertension, reduce the plasma BNP concentration, but the invasive mechanical ventilation has a better curative effect. In clinic, it can contribute to the judgment of the severity and prognosis of the patients with respiratory failure and pulmonary hypertension by monitoring blood plasma BNP concentration.