机械通气对肺部感染患者外周血B型脑钠肽水平的影响及其与患者预后的关系分析

Influence of mechanical ventilation on peripheral blood B-type brain natriuretic peptide levels in patients with pulmonary infection and its relationship with prognosis

目的探讨无创机械通气对肺部感染患者外周血B型脑钠肽(BNP)水平的影响及其与患者预后的关系分析。方法纳入我院2015年1月至2017年4月期间收治的120例肺部感染患者为研究对象,随机分为对照组(60例)和机械通气组(60例),对照组给予常规治疗,机械通气组给予无创机械通气+常规治疗,比较两组外周血BNP水平并分析其与患者预后的关系。结果治疗72 h后,两组患者心率(HR)、呼吸频率(RR)、BNP水平均显著下降(P<0.05),两组患者动脉血氧分压(Pa O2)、动脉二氧化碳分压(PaCO_2)均显著上升(P<0.05),且机械通气组上述指标变化幅度均大于对照组(P<0.05);两组动脉血p H值均恢复正常,且无显著差异(P>0.05);机械通气组平均住院时间(12.65±3.52)d,显著短于对照组的(15.29±4.38)d(P<0.05);机械通气组存活率显著高于对照组(96.67%与86.67%,P<0.05);心功能衰竭组和死亡组BNP水平显著高于心功能正常组(P<0.05),死亡组BNP水平显著高于心力衰竭组(P<0.05)。结论无创机械通气能有效改善肺部感染患者病情,降低外周血BNP水平,改善预后,缩短住院时间和提高患者存活率,外周血BNP水平与患者预后有关,治疗中应予以监测。

Objective To investigate the influence of noninvasive mechanical ventilation on peripheral blood B-type brain natriuretic peptide（ BNP） levels in patients with pulmonary infection and its relationship with prognosis.Methods A total of 120 patients with lung infection treated in our hospital from January 2015 to April 2017 were selected as study subjects,and they were randomly divided into the control group（ 60 cases） and the mechanical ventilation group（ 60 cases）. The control group was given conventional treatment,while the mechanical ventilation group was given noninvasive mechanical ventilation combined with conventional treatment. BNP levels in peripheral blood were compared between the two groups,and the relationship between the levels and the prognosis was analyzed. Results 72 h after treatment,their heart rate（ HR）,respiratory rate（ RR） and BNP levels decreased significantly,while the arterial partial pressure of oxygen（ PaO_2） and arterial partial pressure of carbon dioxide（ PaCO_2） increased significantly in the two groups（ all P〈0. 05）,and the changes were more pronounced in the mechanical ventilation group than in the control group（ P〈0. 05）. The p H value of arterial blood in the two groups returned to normal,and there was no significant difference between the two groups（ P〈0. 05）. The average duration of hospital stay was significantly shorter in the mechanical ventilation group[（ 12. 65 ± 3. 52） d] than in the control group[（ 15. 29 ± 4. 38） d]（ P〈0. 05）,and the survival rate of the mechanical ventilation group was significantly higher than that of the control group（ 96. 67% vs86. 67%,P〈0. 05）. BNP level in the heart failure group and the death group was significantly higher than those in the normal cardiac function group（ P〈0. 05）,and BNP level in the death group was significantly higher than that in the heart failure group（ P〈0. 05）. Conclusion Noninvasive mechanical ventilation can effectively improve the condition of patients with pulmonary infection,reduce the peripheral blood BNP level,improve the prognosis,shorten the duration of hospital stay and improve the survival rate. BNP level in peripheral blood is closely related with the prognosis of patients,which should be monitored during treatment.