氧气驱动雾化吸入联合无创呼吸机治疗急性左心衰竭对脑钠肽水平的影响

The effects of oxygen driven aerosol inhalation combined with noninvasive ventilator on the level of brain natriuretic peptide in patients with acute left heart failure

目的 探讨氧气驱动雾化吸入联合无创呼吸机治疗急性左心衰竭对脑钠肽（BNP）表达的影响.方法 2013年8月到2016年1月选择在我院诊治的急性左心衰竭患者130例,通过随机数字表法分为观察组与对照组,各65例.所有患者均接受常规的抗心力衰竭治疗,对照组给予无创呼吸机治疗,观察组在对照组治疗的基础上给予雾化吸入肝素治疗,两组都治疗观察7d.结果 观察组和对照组的有效率分别为98.5％和89.2％,观察组明显高于对照组（P＜0.05）.观察组和对照组治疗后的血清BNP值分别为（33.62±9.92）ng/L和（56.78±10.95）ng/L,都明显低于治疗前的（129.40± 12.25）ng/L和（130.48± 11.54）ng/L（P＜0.05）,同时观察组治疗后的血清BNP值明显低于对照组（P＜0.05）.观察组和对照组治疗后的LVEF值分别为（47.33±5.33）％和（40.65±6.72）％,都明显高于治疗前的（30.35±6.24）％和（30.45±5.98）％ （P＜0.05）,同时治疗后观察组的LVEF值明显高于对照组（P＜0.05）.两组治疗期间的低血压、眩晕、心动过缓、肺部感染、房室传导阻滞等不良反应发生情况对比未见统计学差异（P＞0.05）.结论 氧气驱动雾化吸入联合无创呼吸机治疗急性左心衰竭安全性良好,能有效改善心功能,提高临床疗效,其作用机制可能与有效抑制BNP表达有关.

Objective To investigate the effects of oxygen driven aerosol inhalation combined with noninvasive ventilator on the level of brain natriuretic peptide （BNP） in patients with acute left heart failure. Methods From August 2013 to January 2016, 130 cases in our hospital for diagnosis and treatment of acute left heart failure patients were selected and were equally divided into the observation group and the control group with 65 cases in eaeh group according to a random number table methods. All patients were underwent conventional anti heart failure treatment, the control group were given non-invasive ventilation in the treatment, the observation group were given the oxygen driven aerosol inhalation combined with noninvasive ventilator treatment, two groups of treatment were observed for 7 days. Results The effective rates of the observation group and the control group were 98.5% and 89.2% respectively that the observation group was significantly higher than that of the control group （P〈0.05）. The serum BNP values in the obseIvation group and the control group after treatment were （33.62±9.92）ng/L and （56.78±10.95）ng/L that were significantly lower than the before treatment of （129.40±12.25）ng/L and （130.48±11.54）ng/L（P〈0.05）, and the serum BNP values in the observation group were significantly lower than those in the control group（P〈0.05 ）. The LVEF values in the observation group and control group after treatment were （47.33±5.33）% and （40.65±6.72）% that were significantly higher than before treatment of （30.35±6.24）% and （30.45±5.98）%（P〈0.05）, and the LVEF values in the observation group after treatment were significantly higher than those in the control group （P〈0.05）. There was no significant difference in the incidence of hypotension, dizziness, tachycardia, pulmonary infection, atrioventricular block and other adverse reactions compared between the two groups during treatment （P〉0.05）. Conclusion Oxygen drive atomization inhalation combined with non invasive ventilation treatment acute left heart failure has better safety, it can effectively improve heart function, improve clinical curative effect and its mechanism may be related to effectively inhibit the expression of BNP.