BiPAP联合参麦注射液救治心源性肺水肿对NT-proBNP及Boston积分的影响

The effects of BiPAP combined shenmai injection on nt-probnp and Boston integrals

目的评价无创性鼻(面)罩双水平气道正压通气(BiPAP)联合参麦注射液救治心源性肺水肿(ACPE)对N端脑钠肽前体(NT-proBNP)及Boston积分的影响。方法采用前瞻性研究方法选取ACPE患者120例,随机分为参麦组、BiPAP组、BiPAP+参麦组和对照组四组,分别采用常规治疗+参麦,常规治疗+BiPAP,常规治疗+参麦+BiPAP和常规治疗四种不同方法进行干预,观察周期为3 d。比较四组患者NT-proBNP、Boston积分、症状缓解时间、抢救成功率情况。结果治疗前四组患者NT-proBNP与Boston积分比较无显著差异(P>0.05),治疗后四组患者NT-proBNP与Boston积分均较治疗前明显改善(P<0.05),但同期比较BiPAP+参麦组改善效果最显著,明显优于对照组、参麦组及BiPAP组(P<0.05),参麦组及BiPAP组改善效果优于对照组(P<0.05),但参麦组与BiPAP组比较并无明显差异(P>0.05)。对照组症状缓解时间明显长于各组,抢救成功率明显低于各组(P<0.05);BiPAP+参麦组患者症状缓解时间明显短于其他组、抢救成功率明显高于其他组(P<0.05),参麦组与BiPAP组比较则无显著差异(P>0.05)。结论 BiPAP联合参麦注射液治疗心源性肺水肿可有效改善患者的NT-proBNP及Boston积分水平,且可提高ACPE抢救成功率、缩短缓解时间,值得临床推广应用。

Objective To evaluate the non-invasive nasal（ surface） cover double level positive airway pressure（ cpap）（ BiPAP） and injection treatment for cardiac pulmonary edema（ ACPE） on N terminal brain natriuretic peptide precursor（ NT-proBNP） and the influence of Boston integrals. Methods 120 cases of ACPE patients were randomly divided into Shenmai group,BiPAP group,BiPAP ＋ Shenmai group and conventional group,who were treated with different methods for 3 d. The time of nt-probnp,Boston integral,symptom remission time and rescue success rate were compared. Results There is no significant difference between the groups before treatment with NT-proBNP Boston score（ P〉 0. 05）,but NT-proBNP and Boston scores were significantly improved after treatment（ P 〈 0. 05）. In the same period,NT-proBNP and Boston scores of BiPAP ＋ Shenmai group improved significantly,which were better than those of the control group,Shenmai group and BiPAP group（ P 〈 0. 05） and those in Shenmai group and BiPAP group were significantly better than that of control group（ P 〈 0. 05）,but Shenmai group compared with BiPAP group,there was no significant difference（ P 〉 0. 05）. The time of symptoms in BiPAP ＋ Shenmai group was shorter than that of other groups,and the rescue success rate was significantly higher than that in other groups（ P 〈 0. 05）,but there was no significant difference between Shenmai group and BiPAP group（ P 〉 0. 05）. Conclusion BiPAP combined shenmai injection can effectively improve the level of nt-probnp and Boston points,and improve the success rate of ACPE rescue and shorten the time of mitigation.