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无创机械通气对急性左心衰竭患者C反应蛋白的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第1期
页码:
73-076
栏目:
临床研究
出版日期:
2013-02-25

文章信息/Info

Title:
Effects of noninvasive mechanical ventilation on Creactive protein changes in patients with acute left ventricular failure
作者:
秦海萍; 高 扬; 罗 明
(同济大学附属上海市同济医院心内科，上海 200072)
Author(s):
QIN Haiping;  GAO Yang;  LUO Ming
(Department of Cardiology, Tongji Hospital, Tongji Uneversity, Shanghai 200072, China)
关键词:
无创机械通气; 急性左心衰竭; C反应蛋白
Keywords:
noninvasive mechanical ventilation;  acute left ventricular failure;  Creactive protein
分类号:
R541.6
DOI:
-
文献标识码:
A
摘要:
目的:观察无创机械通气对急性左心衰竭的治疗作用及其对C反应蛋白（CRP）水平的影响。方法： 将急性左心衰竭患者53例随机分为2组：常规组27例，给予高流量吸氧+药物治疗；无创通气组26例，给予经面罩双水平无创正压通气+药物治疗。观察两组患者治疗后的临床疗效以及CRP水平的变化，并进行相关分析。结果： 无创通气组有效率96%，常规组有效率70%，无创通气组的临床疗效好于常规组（P<005）。治疗后24 h两组CRP水平较治疗前显著下降（P<001），且两组间的差异有统计学意义（P<001）。治疗后两组的收缩压（SBP）、舒张压(DBP)、心率(HR)、呼吸频率(RR)较治疗前明显降低(P<001)，动脉氧分压（PaO2）、血氧饱和度（SpO2）较治疗前明显升高（P<001），治疗后1 h两组间的SBP、DBP、HR、RR、PaO2、SpO2比较，差异均有统计学意义（P<005或P< 001），治疗后24 h两组间的PaO2、SpO2比较，差异有统计学意义（P<001）。结论： 无创机械通气能够提高急性左心衰竭的治疗效果，并能够降低C反应蛋白水平。
Abstract:
AIM:To observe the therapeutic effect of noninvasive mechanical ventilation on patients with acute left ventricular failure and the changes of Creactive protein (CRP). METHODS: A total of 53 patients with acute left heart failure were randomly divided into two groups: conventional group of 27 patients treated with highflow oxygen and routine drug therapy and noninvasive ventilation group of 26 cases treated with bilevel noninvasive positive pressure ventilation via face mask and routine drug therapy. Clinical efficacy and CRP levels in the two groups were assessed. RESULTS: The effective rates in noninvasive ventilation group and conventional group were, respectively, 96% and 70%, with statistically significant differences (P<005). Twentyfour hours after treatment, CRP levels were significantly lower than those before treatment (P<001) and the difference between the two groups was statistically significant (P<001). After treatment, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and respiratory rate (RR) were significantly lower than those before treatment (P<001), whereas PaO2 and SPO2 increased (P<001). One hour after treatment, a statistically significant difference was observed in SBP, DBP, HR, RR, PaO2 and SPO2 between conventional group and noninvasive ventilation group (P<001 or 005). Twentyfour hours after treatment, a statistically significant difference was seen in PaO2 and SPO2 between groups (P<001). CONCLUSION: Noninvasive mechanical ventilation can improve the treatment efficacy in patients with acute left ventricular failure and reduce the level of CRP.

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备注/Memo

备注/Memo:
收稿日期：2012-08-14.通讯作者：罗明，主任医师，主要从事高血压基础与临床心力衰竭研究Email:Lmfc84@Yahoo.com.cn 作者简介：秦海萍，主治医师，硕士生Email:haipingq@126.com
更新日期/Last Update: 2013-03-20