血浆BNP对慢性阻塞性肺疾病有创机械通气撤机的指导价值

Guidance value of plasma BNP on invasive mechanical ventilation weaning of COPD patients

目的探讨撤机前后血浆BNP水平及其变化对慢性阻塞性肺疾病(简称慢阻肺)患者有创机械通气撤机的指导价值。方法回顾性调查满足条件的70例患者,测定患者开始有创机械通气时,自主呼吸试验(SBT)前、后的血浆BNP水平,分别标为(BNP 0、BNP 1、BNP 2),SBT前、后的血浆BNP水平差值(ΔBNP),并根据患者撤机结局分为撤机成功组与撤机失败组。绘制ROC曲线,分析血浆BNP水平对慢阻肺患者撤机结局的预测价值。结果 70例患者中,成功撤机52例,撤机失败18例。BNP 0、BNP 1、BNP 2预测慢阻肺患者撤机失败的AUC分别为0.6079、0.8568、0.9081,ΔBNP预测撤机失败的AUC为0.9466。结论血浆BNP水平对预测慢阻肺患者撤机结局有指导价值,其中ΔBNP预测慢阻肺患者撤机结局的价值最大。

Objective To investigate the guiding value of plasma BNP level and changes before and after weaning in COPD patients received invasive mechanical ventilation .Methods 70 patients were selected in retro-spective review to measure plasma BNP level before and after SBT （ marked as BNP 0, BNP1 and BNP2, respective-ly）, and plasma BNP level difference value （ΔBNP） before and after SBT, when they received invasive mechanical ventilation.Moreover, they were divided into the successful weaning group and the failing weaning group in accord -ance with weaning results .The ROC curve was drawn to analyze the predictive value of plasma BNP level on weaning results.Results In 70 patients, the successful weaning group had 52 patients, and the failing weaning group had 18 patients.AUC of the failing weaning group predicted by BNP 0, BNP1 and BNP2 was 0.6079, 0.8568 and 0.9081, respectively.AUC of the failing weaning group predicted by ΔBNP was 0.9466.Conclusion Plasma BNP level has a guiding value on predicting weaning results of COPD patients , and？ BNP has the biggest value of predicting wea-ning results of COPD patients .