无创正压通气对急性左心衰竭患者血浆高敏肌钙蛋白T水平的影响

摘要

目的 观察无创正压机械通气对急性左心衰竭患者血浆高敏肌钙蛋白T(hs-TnT)水平的影响.方法 选择急性左心衰竭患者46例随机分为两组:常规治疗组20例,正压通气组26例,两组患者分别给予高流量面罩吸氧+药物治疗及经面罩双水平无创正压通气+药物治疗,观察两组治疗后24 h的临床疗效以及血浆hs-TnT水平变化.结果正压通气组的临床疗效好于常规治疗组,差异有统计学意义( P ＜0.05).治疗后两组hs-TnT水平均较治疗前明显下降( P ＜0.05),且两组治疗后PaO2、SpO2、HR、呼吸频率、LVEF比较,差异均有统计学意义( P ＜0.05).结论 无创机械通气能够提高急性左心衰竭的治疗效果,并能进一步降低血浆hs-TnT水平.%Objective To assess the effect of noninvasive positive pressure ventilation on the concentration of plasma hs - troponin T ( hs - TNT ) in patients with acute left ventricular failure.Methods A total of 46 patients with acute left ventricular failure were randomly divided into noninvasive positive pressure ventilation group ( 26 cases ) and oxygen uptake group ( 20 cases ).The oxygen uptake group was given routine therapy and oxygen uptake, and the noninvasive positive pressure ventilation group was given routine therapy and noninvasive positive pressure ventilation.Therapeutic effect and the level of plasma hs- TnT were measured 24h before and after the therapy in the two groups.Results There were statistically significant difference in PaO2 , SpO2 , HR, respiratory rate, LVEF between noninvasive positive pressure ventilation group and oxygen uptake group before treatment ( P ＜ 0.05 ).After treatment, the levels of hs - TnT were both significantly lower than those before treatment ( P＜0.05 ).After treatment, there were statistically significant difference in PaO2 , SpO2 , HR, respiratory rate, LVEF between noninvasive positive pressure ventilation group and oxygen uptake group ( P ＜0.05 ).Conclusion Noninvasive positive pressure ventilation can improve the effectiveness of the treatment and can further decrease the plasma hs - TnT level in patients with acute left ventricular.