BiPAP呼吸机联合坎地沙坦酯对肺心病急性期合并呼吸衰竭老年患者心肺功能及血清内皮素-1、Clara细胞蛋白和Copeptin水平的影响

Effects of BiPAP ventilator combined with candesartan on cardiopulmonary function and serum ET-1, CC16 and Copeptin levels in elderly patients with acute stage of pulmonary heart disease complicated with respiratory failure

目的分析BiPAP呼吸机联合坎地沙坦酯对肺心病急性期合并呼吸衰竭老年患者心肺功能及血清内皮素(ET)-1、Clara细胞蛋白(CC)16、和肽素(Copeptin)水平的影响。方法96例肺心病急性期合并呼吸衰竭老年患者随机分为两组各48例,对照组接受BiPAP无创呼吸机治疗,观察组接受BiPAP无创呼吸机联合坎地沙坦酯治疗。比较两组治疗2 w后的疗效、心肺功能指标及血清ET-1、CC16和Copeptin水平,并统计不良反应发生情况。结果观察组总有效率较对照组显著高(P<0.05)。治疗2个疗程后观察组肺动脉压(PASP)显著低于对照组,而每搏输出量(SV)、射血分数(EF)、舒张早期峰值速度与舒张晚期峰值速度比值(E/A)、1 s用力呼气容积(FEV1)/用力肺活量(FVC)、FEV1%、呼吸流量峰值(PEF)指标水平显著高于对照组(P<0.05)。两组治疗后血清ET-1、CC16和Copeptin水平均显著下降,且观察组降低较多(P<0.05)。主要不良反应为低血压、头痛、恶心、发热等,两组发生率无统计学差异(P=0.726)。结论BiPAP呼吸机联合坎地沙坦酯对老年患者肺心病急性期合并呼吸衰竭疗效显著。

Objective To investigate the effects of BiPAP ventilator combined with candesartan on cardiopulmonary function and serum endothelin(ET)-1,Clara cell protein(CC)16 and Copeptin levels in elderly patients with acute stage pulmonary heart disease complicated with respiratory failure.Methods 96 elderly patients with acute stage pulmonary heart disease complicated with respiratory failure were randomly divided into two groups with 48 cases each.The control group received BiPAP non-invasive ventilator and the observation group received BiPAP non-invasive ventilator combined with candesartan ester.The efficacy,cardiopulmonary function indicators,and serum ET-1,CC16,and Copeptin levels of the two groups were compared after 2 weeks of treatment and the occurrence of adverse reactions were counted.Results The total effective rate was higher in the observation group(P<0.05).After 2 courses of treatment,PASP in the observation group was significantly lower than that in the control group,while SV,EF,E/A,FEV1/FVC,FEV1%and PEF were significantly higher than those in the control group(P<0.05).After treatment,serum ET-1,CC16 and Copeptin levels of patients in the two groups decreased significantly,and the reduction was significant in the observation group(P<0.05).The main adverse reactions were hypotension,headache,nausea and fever,with no statistical difference in incidence(χ2=0.276,P=0.99).Conclusions BiPAP ventilator combined with candesartan ester has a significant effect on acute stage pulmonary heart disease complicated with respiratory failure in elderly patients.