无创双水平气道正压通气对老年急性左心衰竭患者心功能及血浆N端脑钠肽水平影响.doc

无创双水平气道正压通气对老年急性左心衰竭患者心功能及血浆N端脑钠肽水平影响 　　[摘要] 目的 探讨无创双水平气道正压通气（BiPAP）对老年急性左心衰竭患者心功能及血浆 N 端脑钠肽前体（NT-proBNP）水平的影响。 方法 2013年1月～2014年12月，选取104例急性左心衰竭患者为研究对象，按照随机数字表法分为两组，各52例。对照组给予面罩或鼻导管吸氧，研究组给予无创BiPAP呼吸机。比较两组的临床疗效、治疗前后的心功能改善情况和NT-proBNP水平变化情况。 结果 治疗后，研究组的总有效率高于对照组，SV、EF改善情况优于对照组，NT-proBNP水平下降较对照组更明显（P0.05）。 结论 无创BiPAP能显著改善老年左心衰竭患者的心功能、降低NT-proBNP水平，是治疗老年急性左心衰竭的良好方法。 　　[关键词] 双水平气道正压通气；急性左心衰竭；心功能；N 端脑钠肽前体 　　[中图分类号] R541.6 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0042-03 　　[Abstract] Objective To investigate the influence of noninvasive bi-level positive airway pressure （BiPAP） on cardiac function and plasma N-terminal pro-brain natriuretic peptide （NT-proBNP） level of elderly patients with acute left heart failure. Methods From January 2013 to December 2014，104 patients with acute left heart failure were selected as the study subjects and divided into two groups according to the random number table method，and there were 52 patients in each group.Control group was given mask or nasal catheter oxygen uptake and study group was given noninvasive BiPAP ventilator.The clinical efficacy，improvement of heart function and change of NT-proBNP level before and after treatment between two groups was compared respectively. Results After treatment，total effective rate of study group was higher than that of control group，improvement of SV and EF was better than that of control group，and decrease of NT-proBNP level was more obvious than control group （P0.05）. Conclusion Noninvasive BiPAP can significantly improve the heart function and reduce plasma NT-proBNP level in elderly patients with acute left heart failure，which is a good method to treat elderly left heart failure. 　　[Key words] Bi-level positive airway pressure；Acute left heart failure；Cardiac function；N-terminal pro-brain natriuretic peptide 　　心力衰竭（简称心衰）是老年患者常见的疾病之一，临床主要表现为呼吸衰竭及低血氧症[1-2]，机械辅助呼吸是治疗老年心衰最行之有效的方法。报道[3]显示，脑钠肽（brain natriuretic peptide，BNP）等血管活性物质在心衰发生过程中发挥重要作用。随着研究的不断深入，近几年，与 BNP 密切相关的N端脑钠肽前体（N-terminal pro-bra