无创肺动脉压力测定在重症肺炎并呼吸衰竭中的应用价值

The application value of PAP in the severe pneumonia with respiratory failure

目的:探讨无创肺动脉压力(PAP)测定在重症肺炎并呼吸衰竭中的应用价值。方法:选取在本院重症监护室住院的重症肺炎并呼吸衰竭的患者83例,根据PAH的分级诊断标准分组,比较各组机械性通气情况的差异;比较各组治疗前后PAP与各心功能指标的差异;以及治疗前后PAP值与各心功能指标的相关性分析。结果:PAP正常组患者机械通气性率(36.84%)低于轻度PAH(51.85%),中度PAH组(77.27%)和重度PAH组(86.67%),且差异具有统计学意义(P<0.05);PAP正常组机械性通气时间(4.54±1.34)d低于轻度PAH组(6.25±0.96)d,中度PAH组(7.37±1.27)d和重度PAH组(9.39±1.25)d,且差异具有统计学意义(P<0.05)。治疗前各PAH组的PAP和LVEF均高于PAP正常组,且差异具有统计学意义(P<0.05);治疗后各PAH组的PAP与治疗前比较均降低,且差异具有统计学意义(P<0.05);治疗后中度PAH组和重度PAH组的LVEF与治疗前比较均升高,差异具有统计学意义(P<0.05)。治疗前PAP值与治疗前LVEF呈正相关(r=0.316,P=0.018),与治疗前EA呈负相关(r=-0.297,P=0.027);治疗后PAP值与治疗后LVEF呈正相关(r=0.253,P=0.030)。结论:PAP测定在重症肺炎并呼吸衰竭中有一定的临床应用价值,且PAP与部分心功能指标显著相关。

Objective：To investigate the application value of PAP in the severe pneumonia with respiratory failure.Method：Eighty-three cases of severe pneumonia with respiratory failure in ICU of our hospital were selected,according to the classification criteria of PAH group,the differences of mechanical ventilation were compared among the groups;The differences of PAP and cardiac function indexes were compared before and after treatment in each group;Correlation analysis between PAP value and cardiac function indexes before and after treatment.Result：The mechanical ventilation rate in PAP normal groups（36.84%）was lower than that in the mild PAH group（51.85%）,moderate PAH group（77.27%）and severe PAH group（86.67%）,and the difference is statistically significant（P〈0.05）;The mechanical ventilation time in the normal group（4.54±1.34）d was lower than that in the mild PAH group（6.25±0.96）d,moderate PAH group（7.37±1.27）D and severe PAH group（9.39±1.25）d,and the difference was statistically significant（P〈0.05）.The PAP and LVEF of each PAH group before treatment were higher than the PAP normal group,and the difference was statistically significant（P〈0.05）;The PAP value of each PAH group after treatment was lower than that before treatment,and the difference was statistically significant（P〈0.05）;The LVEF in the mild PAH group and the severe PAH group after treatment were higher than before,and the difference was statistically significant（P〈0.05）.The PAP value before treatment was positively correlated with LVEF（r=0.316,P=0.018）,and was negatively correlated with EA（r=-0.297,P=0.027）;PAP value after treatment was positively correlated with LVEF（r=0.253,P=0.030）.Conclusion：PAP measurement in severe pneumonia with respiratory failure has a certain clinical application value,and PAP value was significantly correlated with some cardiac function indexes.