参麦注射液联合无创正压通气治疗慢性阻塞性肺疾病合并呼吸衰竭的临床观察

目的:观察参麦注射液联合无创正压通气治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭的疗效及其对患者血清脑钠肽(BNP)、纤维蛋白原和D-二聚体水平的影响。方法:选取2010年1月至2012年1月我院收治的COPD合并急性呼吸衰竭患者120例,随机分为观察组和对照组,每组各60例,对照组予以常规治疗,观察组在对照组的基础上予以无创正压通气和参麦注射液治疗,观察和比较两组治疗前后的pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2),、氧合指数(PaO2/FiO2)、纤维蛋白原、D-二聚体和BNP水平的变化。结果:治疗后,两组的pH、PaO2和PaO2/FiO2均较治疗前明显升高(P0.01),且观察组PaO2/FiO2水平较对照组升高更为明显(P0.05);两组PaCO2、纤维蛋白原、D-二聚体和BNP水平均较治疗前明显降低(P0.01),且观察组以上指标水平明显低于对照组(P0.01)。结论:参麦注射液联合无创正压通气治疗COPD合并呼吸衰竭的疗效显著,并可显著降低患者血浆BNP、纤维蛋白原和D-二聚体水平。

Clinical Observation on the Efficacy of Shenmai injection combined with Non-invasive Positive Pressure Ventilation in the treatment of Patients with Chronic Obstructive Pulmonary Cisease Plus Respiratory Failure

Objective： To observe the efficacy of Shenmai injection combined with non-invasive positive pressure ventilation in the treatment of patients with chronic obstructive pulmonary disease （COPD） plus respiratory failure and its effect on the serum levels of brain natriuretic peptide （BNP）, fibrinogen and D-dimer. Methods： 120 patients with COPD plus acute respiratory failure, admitted from January 2010 to January 2012, were randomly divided into the observation group and control group, 60 cases in each group. The control group was given the conventional treatment, the observation group was treated with Shen Mai injection combined with noninvasive positive pressure ventilation on the basis of control group, the levels of pH, arterial oxygen pressure （PaO2）, arterial partial pressure of carbon dioxide （PaCO2）, oxygenation index （PaOCFiO2）, fibrinogen, D dimer and BNP were observed and compared before and after treatment. Results： After treatment, the levels of pH, PaO2 and PaO2/FiO2 were significantly higher in two groups than those before treatment （P〈0.01）, while the levels of PaOJFiO2 increased more significantly compared with the control group （P〈0.05）. The levels of PaCO2, fibrinogen, D-dimer and BNP were significantly lower than those before treatment （P〈0.01）, while the reduced levels were more obvious in the observation group （P〈0.01）. Conclusion： Shenmai injection combined with non-invasive positive pressure ventilation was more effective to the COPD patients with respiratory failure, which obvioulsy increased the serum BNP, fibrinogen and D-dimer levels.