| 摘要: |
| 目的评估慢性阻塞性肺疾病急性加重期患者住院治疗使用无创机械通气治疗后患者血清超敏C反应蛋白(CRP)及血浆脑钠肽(brain natriuretic peptide,BNP)表达的影响。方法连续选取2015年7月至2016年10月大连医科大学附属第一医院呼吸内科住院治疗的急性加重期慢阻肺患者24例,给予无创通气治疗。通过CAT评分对患者慢阻肺症状进行评估;留取无创通气治疗前及治疗1周后受试者空腹静脉血清,血浆分别用于检测hs CRP、BNP水平,同时测定动脉血气分析。结果本研究共纳入24例急性加重期慢阻肺患者,其中入院前6个月内稳定期肺功能分级III级8例,IV级16例;男18例,女6例。无创机械通气治疗后患者动脉血氧分压、二氧化碳分压及患者CAT评分均较治疗前有所改善,差异有统计学意义(P<0.05);治疗前后患者血清hs CRP及血浆BNP水平的较前改善,差异有统计学意义(P<0.05)。结论慢性阻塞性肺疾病急性加重期患者经无创正压通气治疗后患者临床症状和相应指标改善,且hs CRP及BNP水平随之下降;其可能归因于无创通气治疗改善慢阻肺患者改善炎症反应水平和心脏负荷,从而改善患者预后。 |
| 关键词: 慢性阻塞性肺疾病 气道炎症 C反应蛋白 无创通气 脑钠肽 |
| DOI： |
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| 基金项目:辽宁省科技厅资助项目(编号:2015305010);辽宁省卫生计生委资助项目(编号:2015B004) |
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| Effect of Noninvasive Mechanical Ventilation on the Expression of Serum Brain Natriuretic Peptide in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
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Li Yanxia;Liu Zhuo;Yin Yan
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1.Department of Respiratory Medicine,the First Affiliated Hospital of Dalian Medical University;2.Institute of respiratory diseases,the First Affiliated Hospital of China Medical University
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| Abstract: |
| Objective To assess the effects of noninvasive mechanical ventilation on the expression of serum high-sensitivity C reactive protein(hs CRP) and brain natriuretic peptide(BNP) in the treatment of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods 24 patients with AECOPD received in the department of respiratory medicine,the First Affiliated Hospital of Dalian Medical University during July 2015 to October 2016 were included and treated with noninvasive ventilation. Symptoms of COPD were evaluated by CAT score. Fasting venous serum and plasma samples both before noninvasive ventilation treatment and 1-week after treatment were preserved for determination of hs CRP and BNP,and simultaneously,arterial blood gas analysis was processed. Results 24 cases of AECOPD were included in this study,among which there were 8 cases of grade Ⅲ pulmonary function and 16 cases of grade Ⅳ pulmonary function during stable phase of COPD,6 months before admission. There were 18 male patients and 6 female patients. After noninvasive mechanical ventilation,arterial partial pressure of oxygen as well as carbon dioxide and CAT scores of patients were improved when compared with pretreated condition,the difference being statistically significant(P<0. 05). The post-treatment serum hs CRP and BNP level of patients improved when compared with pretreated level,the difference being statistically significant(P<0. 05). Conclusion Clinical symptoms and corresponding indicators of AECOPD patients improve after noninvasive positive-pressure ventilation,and hs CRP as well as BNP level drop subsequently,which may be attributed to the improvement of inflammatory responses and cardiac load of COPD patients by noninvasive ventilation,thus improving the prognosis of patients. |
| Key words: chronicobstructivepulmonarydisease airwayinflammation c-reactiveprotein noninvasiveventilation brainnatriureticpeptide |
