Effect of nasal intermittent positive pressure ventilation on N-terminal pro-brain natriuretic peptide in patients with acute exacerbations of chronic obstructive pulmonary disease and type Ⅱ respiratory failure
Author(s): WANG Yina, YANG Yu, CHEN Ping, LUO Yingquan, YANG Yue
Pages: 325-331
Year: 2012 Issue: 4
Journal: Journal of Central South University(Medical Science)
Keyword: N端脑利钠肽前体; 慢性阻塞性肺疾病; Ⅱ型呼吸衰竭; 无创正压通气;
Abstract: 目的:观察无创正压通气( nasal inlermittent positive pressure ventilation,NIPPV)对慢性阻塞性肺疾病急性加重(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者血浆N端脑利钠肽(N-terminal pro-brain natriuretic peptidc,NT-proBNP)水平的影响并探讨其.意义.方法:随机选择AECOPD合并Ⅱ型呼吸衰竭患者及慢性阻塞性肺疾病稳定期患者各40例,检测血浆NT-proBNP水平并分析其与动脉血气、APACIIE Ⅱ评分及肺动脉压力之间的相关性;比较两组血浆NT-proBNP水平;比较NIPPV治疗前后AECOPD合并Ⅱ型呼吸衰竭患者血浆NT-proBNP水平.结果:血浆NT-proBNP与pH值、PaO2呈负相关(分别为r=-0.691和r=-0.704,均P＜0.001),与PaCO2或APACHEⅡ评分呈正相关(分别为r=0.774和r=0.810,均P＜0.001),与肺动脉压力呈正相关(r=0.965,P＜0.001); AECOPD合并Ⅱ型呼吸衰竭患者血浆NT-proBNP与pH值、PaO2呈负相关(分别为r=-0.636和r=-0.616,均P＜0.001),与 PaCO2,APACHEⅡ评分呈正相关(分别为r-0.545和r=0.475, P=0.001.P=0.002),与肺动脉压力呈正相关(r-0.833,P＜0.001); AECOPD合并Ⅱ型呼吸衰竭组血浆NT-proBNP明显高于慢性阻塞性肺疾病稳定期组[(939.60±250.00 ) pg/mLvs(151.55 ± 111.20) pg/mL,P＜0.01];NIPPV治疗24 h后血气指标好转、APACHEⅡ评分下降,血浆NT-proBNP较治疗前下降[(229.15±98.26) pg/mL vs (939.60±250.00) pg/mL,p＜0.01];治疗后肺动脉压力较治疗前下降,但差异无统计学意义(P=0.056).结论:血浆NT-proBNP浓度反映了AECOPD合并Ⅱ型呼吸衰竭患者病情的严重程度;NIPPV能降低该类患者的血浆NT-proBNP浓度,NT-proBNP浓度变化有助于评价NIPPV疗效.
Pages: 325-331
Year: 2012 Issue: 4
Journal: Journal of Central South University(Medical Science)
Keyword: N端脑利钠肽前体; 慢性阻塞性肺疾病; Ⅱ型呼吸衰竭; 无创正压通气;
Abstract: 目的:观察无创正压通气( nasal inlermittent positive pressure ventilation,NIPPV)对慢性阻塞性肺疾病急性加重(acute exacerbations of chronic obstructive pulmonary disease,AECOPD)合并Ⅱ型呼吸衰竭患者血浆N端脑利钠肽(N-terminal pro-brain natriuretic peptidc,NT-proBNP)水平的影响并探讨其.意义.方法:随机选择AECOPD合并Ⅱ型呼吸衰竭患者及慢性阻塞性肺疾病稳定期患者各40例,检测血浆NT-proBNP水平并分析其与动脉血气、APACIIE Ⅱ评分及肺动脉压力之间的相关性;比较两组血浆NT-proBNP水平;比较NIPPV治疗前后AECOPD合并Ⅱ型呼吸衰竭患者血浆NT-proBNP水平.结果:血浆NT-proBNP与pH值、PaO2呈负相关(分别为r=-0.691和r=-0.704,均P＜0.001),与PaCO2或APACHEⅡ评分呈正相关(分别为r=0.774和r=0.810,均P＜0.001),与肺动脉压力呈正相关(r=0.965,P＜0.001); AECOPD合并Ⅱ型呼吸衰竭患者血浆NT-proBNP与pH值、PaO2呈负相关(分别为r=-0.636和r=-0.616,均P＜0.001),与 PaCO2,APACHEⅡ评分呈正相关(分别为r-0.545和r=0.475, P=0.001.P=0.002),与肺动脉压力呈正相关(r-0.833,P＜0.001); AECOPD合并Ⅱ型呼吸衰竭组血浆NT-proBNP明显高于慢性阻塞性肺疾病稳定期组[(939.60±250.00 ) pg/mLvs(151.55 ± 111.20) pg/mL,P＜0.01];NIPPV治疗24 h后血气指标好转、APACHEⅡ评分下降,血浆NT-proBNP较治疗前下降[(229.15±98.26) pg/mL vs (939.60±250.00) pg/mL,p＜0.01];治疗后肺动脉压力较治疗前下降,但差异无统计学意义(P=0.056).结论:血浆NT-proBNP浓度反映了AECOPD合并Ⅱ型呼吸衰竭患者病情的严重程度;NIPPV能降低该类患者的血浆NT-proBNP浓度,NT-proBNP浓度变化有助于评价NIPPV疗效.
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