摘要
目的探讨血浆氨基末端脑钠肽前体(NT-proBNP)对慢性阻塞性肺疾病急性加重(AECOPD)机械通气撤机的指导意义,为临床提高AECOPD患者的抢救成功率提供依据。方法 60例AECOPD行有创机械通气患者,按照撤机成功与否分为成功组(34例)和失败组(26例)。观察对比两组患者血浆NT-proBNP水平、肺的顺应性情况及两组患者脱机前的肺通气情况。结果两组患者脱机前氧分压、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分比较,差异均无统计学意义(t=0.942、0.080,P>0.05);成功组脱机前二氧化碳分压低于失败组,机械通气时间短于失败组,差异具有统计学意义(t=4.971、5.955,P<0.05)。成功组患者血浆NT-proBNP为(1429.32±201.37)pg/ml,显著高于失败组的(890.21±106.37)pg/ml,肺顺应性为(63.09±8.71)ml/cm H_2O,显著优于对照组的(51.62±7.41)ml/cm H_2O,差异均具有统计学意义(P<0.05)。结论 NT-proBNP对AECOPD机械通气撤机有指导意义,临床医师可根据患者血浆NT-proBNP的水平对患者进行适时的撤机,以提高撤机成功率。
Objective To explore guiding significance of N-terminal pro-brain natriuretic peptide（NTproBNP） for mechanical ventilation withdrawal in acute exacerabation of chronic obstructive pulmonary disease（AECOPD）, to provide basis for increasing clinical rescue success rate in AECOPD patients. Methods A total of 60 AECOPD patient performing mechanical ventilation withdrawal were divided by successful withdrawal or not into successful group（34 cases） and failure group（26 cases）. Observation and comparison were made on serum NT-proBNP level, compliance of lung and lung ventilation before offline in two groups. Results There were no statistically significant difference in oxygen partial pressure, acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） before offline in two groups（t=0.942, 0.080, P〉0.05）. The successful group had lower oxygen partial pressure than the failure group, and shorter mechanical ventilation time than the failure group. Their differences had statistical significance（t=4.971, 5.955, P〈0.05）. The successful group had higher serum NTproBNP as（1429.32±201.37） pg/ml than（890.21±106.37） pg/ml in the failure group, better compliance of lung as（63.09±8.71） ml/cm H2O than（51.62±7.41） ml/cm H2O in the failure group. Their differences had statistical significance（P〈0.05）. Conclusion NT-proBNP provides guiding significance for mechanical ventilation withdrawal in AECOPD, and Clinicians can timely withdraw machine of patients according to the level of plasma NT-proBNP in patients, in order to improve the success rate of withdrawal.
出处
《中国实用医药》
2017年第1期42-44,共3页
China Practical Medicine
关键词
慢性阻塞性肺疾病急性加重
血浆氨基末端脑钠肽前体
机械通气
撤机
Acute exacerabation of chronic obstructive pulmonary disease
N-terminal pro-brain natriuretic peptide
Mechanical ventilation
Withdrawal
