机械通气对肺动脉高压伴呼吸衰竭患者血浆脑钠肽水平的影响

摘要

ObjectiveTo investigate the effect of mechanical ventilation on plasma brain natriuretic peptide level in patients with pulmonary hypertension complicated with respiratory failure.Method136 patients with pulmonary hypertension complicated with respiratory failure treated in our hospital from March 2012 to May 2015 were selected as the study objects. They were randomly divided into study group and control group, 68 cases in each group. Study group patients were given a positive pressure ventilator treatment based on conventional treatment. While patients in control group were given noninvasive positive pressure ventilation based on conventional treatment. Compared all patients' blood pH, BNP levels and pulmonary arterial pressure before and after treatment.ResultBefore treatment, the blood pH, arterial oxygen pressure, arterial carbon dioxide pressure and blood oxygen saturation in both groups showed no signiifcant differences (P>0.05). The above-mentioned indexes in both groups after treatment were significantly better than before treatment (P<0.05). All the indexes in study group were signiifcantly better than control group (P<0.05). There were no signiifcant differences in plasma brain natriuretic peptide and pulmonary artery pressure between the two groups before treatment (P>0.05). Plasma brain natriuretic peptide and pulmonary arterial pressure were significantly decreased after treatment in the two groups (P<0.05). Compared with control group, study group decreased significantly (P<0.05).ConclusionPositive pressure mechanical ventilation applying in pulmonary arterial hypertension complicated with respiratory failure can rapidly improve the patient's respiratory function, optimize the hemodynamic level, relieve cardiac load, reduce the BNP level, eliminate the precipitating factors of pulmonary hypertension and ultimately ease the pulmonary hypertension.%目的：探讨机械通气对肺动脉高压伴呼吸衰竭患者血浆脑钠肽水平的影响。方法将本院2012年3月至2015年5月确诊并收治的136例肺动脉高压伴呼吸衰竭患者按照随机数表法分为研究组和对照组，每组各68例。两组患者均给予常规治疗，研究组患者在常规治疗基础上给予有创正压呼吸机治疗，对照组在常规治疗基础上给予无创正压呼吸机治疗。对比两组患者治疗前及撤机后血液pH、血浆脑钠肽水平及肺动脉压。结果两组患者治疗前血液pH、动脉氧分压、动脉二氧化碳分压及血氧饱和度比较差异均无显著性（P＞0.05），治疗后两组患者上述指标均较治疗前显著改善（P＜0.05），研究组较对照组改善明显（P＜0.05）。两组患者治疗前血浆脑钠肽水平及肺动脉压比较差异均无显著性（P＞0.05）；两组患者治疗后血浆脑钠肽水平及肺动脉压均较治疗前明显下降（P＜0.05），研究组较对照组下降显著（P＜0.05）。结论肺动脉高压伴呼吸衰竭实施有创正压机械通气可迅速改善患者呼吸功能，优化血流动力学水平，减轻心脏负荷，降低脑钠肽水平，根除患者肺动脉高压发生的诱因，最终缓解肺动脉高压。