机械通气对急重症肺动脉高压伴呼吸衰竭患者血浆脑钠肽水平的影响

Influence of mechanical ventilation on plasma brain natriuretic peptide level in acute and severe pulmonary hypertension patients complicated with respiratory failure

目的分析机械通气对急重症肺动脉高压伴呼吸衰竭患者血浆脑钠肽(BNP)水平的影响。方法选取100例肺动脉高压伴呼吸衰竭患者,将其随机分为有创组和无创组各50例。有创组患者在常规对症治疗的基础上给予有创机械通气治疗,无创组患者在常规对症治疗的基础上给予无创机械通气治疗。对2组患者治疗前及治疗后1 d的动脉血气指标、肺动脉压力、血浆BNP水平等指标进行检测和比较。结果 2组患者治疗前的动脉血气指标、肺动脉压及血浆BNP水平的差异均无统计学意义(P>0.05);治疗1 d后,有创组患者各项动脉血气指标均显著优于无创组(P<0.05)。有创组患者治疗后的肺动脉压及血浆BNP水平均显著低于无创组(P<0.05)。结论对于急重症肺动脉高压合并呼吸衰竭患者应用有创机械通气治疗,能够有效地缓解患者的低氧血症和酸中毒症状,降低肺动脉压力和血浆BNP水平,有利于提高救治成功率,改善患者的预后。

Objective To analyze the influence of mechanical ventilation on plasma brain natriuretic peptide（ BNP） level in patients with acute and severe pulmonary hypertension complicated with respiratory failure. Methods A total of 100 pulmonary hypertension patients complicated with respiratory failure were randomly divided into trauma group and non-trauma group,with 50 cases in each group. The patients of both groups were given routine nursing,and trauma group were additionally treated with invasive mechanical ventilation,while the non-trauma group was treated with non-invasive mechanical ventilation. The arterial blood and gas indices,the pulmonary artery pressures,the plasma BNP levels of two groups before treatment and after 1 d of the treatment were compared. Results Before treatment,there were no statistically significant differences in the arterial blood gas indices,the pulmonary artery pressures,the plasma BNP levels between the two groups（ P〈0. 05）.After 1 d of treatment,the arterial blood gas indices were significantly better,and the pulmonary artery pressure and the plasma BNP level were significantly lower in trauma group than that in the nontrauma group,and the differences between the two groups were statistically significant（ P〈0. 05）.Conclusion Invasive mechanical ventilation in treatment of pulmonary hypertension patients with respiratory failure can effectively relieve the hypoxemia and the acidosis symptoms,reduce the pulmonary artery pressure and the plasma BNP level,and improve the treatment success rate and the prognosis of the patients.