中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
22期
12-14
,共3页
韩俊愈%李卫华%郭拥军%谢强
韓俊愈%李衛華%郭擁軍%謝彊
한준유%리위화%곽옹군%사강
连续气道正压通气%面罩%心力衰竭%脑利钠肽
連續氣道正壓通氣%麵罩%心力衰竭%腦利鈉肽
련속기도정압통기%면조%심력쇠갈%뇌리납태
Continuous positive airway pressure%Masks%Heart failure%Brain natriuretic peptide
目的 观察面罩双水平气道内正压(BiPAP)联合重组人脑利钠肽(rhBNP)对急性心力衰竭治疗的短期及长期影响.方法 100例急性心力衰竭患者按随机数字表法分为BiPAP联合rhBNP组(51例)和常规治疗组(49例).常规治疗组给予常规抗心力衰竭药物治疗,BiPAP联合rhBNP组在常规治疗的基础上,给予BiPAP联合rhBNP治疗,观察记录两组患者治疗前及治疗后30 min、2h的动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、临床表现的变化,随访3个月,比较两组心血管事件发生率、超声心动图相关指标及6 min步行试验距离的差异.结果 两组患者治疗后临床症状(呼吸频率、心率)及血气分析指标(PaO2、SaO2)均显著改善,并且BiPAP联合rhBNP组改善更显著,差异均有统计学意义(P＜0.05).随访3个月后,BiPAP联合rhBNP组心血管事件发生率[17.6％(9/51)]显著低于常规治疗组[38.8％(19/49)],差异有统计学意义(P＜0.05).BiPAP联合rhBNP组左室舒张末期内径(LVEDd)、左室射血分数(LVEF)较常规治疗组有明显改善[(55.0±6.1)mm比(63.3 ±6.5) mm,(52.5±7.2)％比(44.7±6.8)％],差异有统计学意义(P＜0.05).BiPAP联合rhBNP组6min步行试验距离显著高于常规治疗组[(325.6±36.4)m比(210.2±34.1) m],差异有统计学意义(P＜0.05).结论 BiPAP联合rhBNP治疗急性心力衰竭短期疗效显著,安全性高,而且可以改善患者的长期预后.
目的 觀察麵罩雙水平氣道內正壓(BiPAP)聯閤重組人腦利鈉肽(rhBNP)對急性心力衰竭治療的短期及長期影響.方法 100例急性心力衰竭患者按隨機數字錶法分為BiPAP聯閤rhBNP組(51例)和常規治療組(49例).常規治療組給予常規抗心力衰竭藥物治療,BiPAP聯閤rhBNP組在常規治療的基礎上,給予BiPAP聯閤rhBNP治療,觀察記錄兩組患者治療前及治療後30 min、2h的動脈血氧分壓(PaO2)、動脈血氧飽和度(SaO2)、臨床錶現的變化,隨訪3箇月,比較兩組心血管事件髮生率、超聲心動圖相關指標及6 min步行試驗距離的差異.結果 兩組患者治療後臨床癥狀(呼吸頻率、心率)及血氣分析指標(PaO2、SaO2)均顯著改善,併且BiPAP聯閤rhBNP組改善更顯著,差異均有統計學意義(P＜0.05).隨訪3箇月後,BiPAP聯閤rhBNP組心血管事件髮生率[17.6％(9/51)]顯著低于常規治療組[38.8％(19/49)],差異有統計學意義(P＜0.05).BiPAP聯閤rhBNP組左室舒張末期內徑(LVEDd)、左室射血分數(LVEF)較常規治療組有明顯改善[(55.0±6.1)mm比(63.3 ±6.5) mm,(52.5±7.2)％比(44.7±6.8)％],差異有統計學意義(P＜0.05).BiPAP聯閤rhBNP組6min步行試驗距離顯著高于常規治療組[(325.6±36.4)m比(210.2±34.1) m],差異有統計學意義(P＜0.05).結論 BiPAP聯閤rhBNP治療急性心力衰竭短期療效顯著,安全性高,而且可以改善患者的長期預後.
목적 관찰면조쌍수평기도내정압(BiPAP)연합중조인뇌리납태(rhBNP)대급성심력쇠갈치료적단기급장기영향.방법 100례급성심력쇠갈환자안수궤수자표법분위BiPAP연합rhBNP조(51례)화상규치료조(49례).상규치료조급여상규항심력쇠갈약물치료,BiPAP연합rhBNP조재상규치료적기출상,급여BiPAP연합rhBNP치료,관찰기록량조환자치료전급치료후30 min、2h적동맥혈양분압(PaO2)、동맥혈양포화도(SaO2)、림상표현적변화,수방3개월,비교량조심혈관사건발생솔、초성심동도상관지표급6 min보행시험거리적차이.결과 량조환자치료후림상증상(호흡빈솔、심솔)급혈기분석지표(PaO2、SaO2)균현저개선,병차BiPAP연합rhBNP조개선경현저,차이균유통계학의의(P＜0.05).수방3개월후,BiPAP연합rhBNP조심혈관사건발생솔[17.6％(9/51)]현저저우상규치료조[38.8％(19/49)],차이유통계학의의(P＜0.05).BiPAP연합rhBNP조좌실서장말기내경(LVEDd)、좌실사혈분수(LVEF)교상규치료조유명현개선[(55.0±6.1)mm비(63.3 ±6.5) mm,(52.5±7.2)％비(44.7±6.8)％],차이유통계학의의(P＜0.05).BiPAP연합rhBNP조6min보행시험거리현저고우상규치료조[(325.6±36.4)m비(210.2±34.1) m],차이유통계학의의(P＜0.05).결론 BiPAP연합rhBNP치료급성심력쇠갈단기료효현저,안전성고,이차가이개선환자적장기예후.
Objective To observe the short-term and long-term effect of mask bi-level positive airway pressure (BiPAP) combined with recombinant human brain natriuretic peptide (rhBNP) on acute heart failure.Methods One hundred cases of acute heart failure patients were divided into BiPAP combined with rhBNP group (51 cases) and conventional treatment group (49 cases) by random digits table.Conventional treatment group was given routine drug for heart failure treatment,and BiPAP combined with rhBNP group on the basis of routine treatment,was given BiPAP combined therapy with rhBNP.Arterial blood oxygen partial pressure (PaO2),arterial blood oxygen saturation (SaO2),and the change of clinical symptoms were recorded before and 30 min,2 h after treatment.All patients were followed up for 3 months,and cardiovascular events,related parameters of echocardiography and 6 min walking distance test were compared between two groups.Results Clinical symptoms (respiratory frequency and heart rate) and blood gas analysis index (PaO2,SaO2) were significantly improved after treatment in two groups,and BiPAP combined with rhBNP group improved more significantly.There was significant difference (P ＜ 0.05).After 3 months' follow-up,the incidence of cardiovascular events in BiPAP combined with rhBNP group was lower than that in conventional treatment group [17.6％ (9/51) vs.38.8％ (19/49),P ＜ 0.05].The left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF) in BiPAP combined with rhBNP group was better than that in conventional treatment group [(55.0 ± 6.1) mm vs.(63.3 ± 6.5) mm,(52.5 ±7.2)％ vs.(44.7 ± 6.8)％] (P ＜ 0.05).The 6 min walking distance test in BiPAP combined with rhBNP group was higher than that in conventional treatment group [(325.6 ± 36.4) m vs.(210.2 ± 34.1) m] (P ＜0.05).Conclusion BiPAP combined with rhBNP in short-term treatment of acute heart failure is effective and safe,and can improve the long-term prognosis of patients.
