无创正压通气联合药物治疗急性左心衰竭的效果及对患者生物学标记物水平的影响

doi:10.3969/j.issn.1007-3205.2020.10.002

河北医科大学学报 ›› 2020, Vol. 41 ›› Issue (10): 1121-1125.doi: 10.3969/j.issn.1007-3205.2020.10.002

无创正压通气联合药物治疗急性左心衰竭的效果及对患者生物学标记物水平的影响

承德医学院附属医院老年病科，河北承德 067000

出版日期:2020-10-25 发布日期:2020-10-27
作者简介:辛秋平（1986-），女，河北承德人，承德医学院附属医院主治医师，医学硕士，从事老年医学疾病诊治研究。

Efficacy of noninvasive positive pressure ventilation combined with drugs in the treatment of acute left heart failure and its effects on the levels of biological markers

Department of Geriatrics, Affiliated Hospital of Chengde Medical College, Hebei Province, Chengde 067000, China

Online:2020-10-25 Published:2020-10-27

摘要/Abstract

摘要： 目的探究无创正压通气（noninvasive positive pressure ventilation，NIPPV）联合药物治疗急性左心衰竭的临床效果。
方法选取急性左心衰竭患者104例为受试对象，按照随机数字表分为联合组与对照组各52例。对照组仅给予常规药物治疗，联合组在其基础上联合NIPPV进行治疗。比较治疗前及治疗3 d后，2组患者血浆心力衰竭标记物［心肌钙蛋白I（cardiac troponin I，cTnI）、N末端-脑利钠肽原（N-terminal pro-brain natriuretic peptide，NT-proBNP）、中段-心房利钠肽原（mid-atrial natriuretic peptide，MR-proANP）］、炎症因子［白细胞介素6（interleukin-6，IL-6）、C反应蛋白（C-reactive protein，CRP）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）］及动脉血气指标［氧分压（partial pressure of oxygen，PaO2）、二氧化碳分压（partial pressure of carbon dioxide，PaCO2）、碱剩余（base excess，BE）］、超声心动图指标［左心室射血分数（left ventricular ejection fraction，LVEF）、每搏心输出量（stroke volume，SV）、心排血指数（cardiac index，CI）］变化。
结果治疗3 d后，2组血浆cTnI、NT-proBNP、MR-proANP、IL-6、CRP、TNF-α及PaCO2水平均较治疗前有显著下降，且联合组明显低于同一时间对照组（P＜0.05）；2组PaO2、BE及LVEF、SV、CI水平均较治疗前有显著提升，且联合组明显高于同一时间对照组（P＜0.05）。
结论 NIPPV联合药物治疗急性左心衰竭能取得较为理想的疗效，对尽快控制机体炎症反应、稳定内环境平衡并恢复心功能有利。

关键词: 心力衰竭, 连续气道正压通气, 生物学标记

Abstract: Objective To explore the clinical effects of noninvasive positive pressure ventilation(NIPPV) combined with drugs in the treatment of acute left heart failure.
Methods A total of 104 patients with acute left heart failure were selected as study subjects. According to the random number table method, the patients were divided into combined group and control group, with 52 cases in each group. Control group was given only conventional drug therapy, and combination group was combined with NIPPV on this basis. The plasma heart failure markers ［cardiac troponin I(cTnI), N-terminal pro-brain natriuretic peptide(NT-proBNP), mid-atrial natriuretic peptide(MR-proANP)］, inflammatory factors ［interleukin-6(IL-6), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α)］ and arterial blood gas indicators ［partial pressure of oxygen(PaO2), partial pressure of carbon dioxide(PaCO2), base excess(BE)］ and echocardiographic indexes ［left ventricular ejection fraction(LVEF), stroke volume(SV), cardiac index(CI)］ were compared between two groups before treatment and after 3 d of treatment.
Results After 3 d of treatment, the levels of plasma cTnI, NT-proBNP, MR-proANP, IL-6, CRP, TNF-α and PaCO2 in two groups were significantly lower than those before treatment, and the levels in combined group were significantly lower than those in control group at the same time(P＜0.05). The levels of PaO2, BE and LVEF, SV and CI in two groups were significantly higher than those before treatment, and the levels in combined group were significantly higher than those in control group at the same time(P＜0.05).
Conclusion NIPPV combined with drugs for acute left heart failure can achieve ideal efficacy, and it is beneficial to control the body inflammatory response, stabilize the internal environment balance and restore cardiac function as soon as possible.

Key words: heart failure, continuous positive airway pressure, biological markers

辛秋平, 高志旭, 曲忠慧. 无创正压通气联合药物治疗急性左心衰竭的效果及对患者生物学标记物水平的影响[J]. 河北医科大学学报, 2020, 41(10): 1121-1125.

XIN Qiu-ping, GAO Zhi-xu, QU Zhong-hui. Efficacy of noninvasive positive pressure ventilation combined with drugs in the treatment of acute left heart failure and its effects on the levels of biological markers[J]. Journal of Hebei Medical University, 2020, 41(10): 1121-1125.

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无创正压通气联合药物治疗急性左心衰竭的效果及对患者生物学标记物水平的影响

Efficacy of noninvasive positive pressure ventilation combined with drugs in the treatment of acute left heart failure and its effects on the levels of biological markers

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