【摘要】 目的观察长期无创机械通气对肺心病右心室结构及功能的改善作用。方法采用病例-对照研究,对纳入本研究患者随机分为观察组(27例)与对照组(25例),观察组在常规治疗基础上,采用长期无创机械通气治疗1年,观察治疗前后肺动脉收缩压、右心室结构参数如右心室流出道内径(RVOT)、右心室舒服张末期内径(RVD)、右心室壁厚度(RVWT)、右肺动脉内径(RPA)、左、右心室内径的比值(LV/RV)和脑钠肽前体(pro-BNP)等指标。结果两组患者治疗后pro-BNP明显降低,与治疗前比较差异有统计学意义(P<0.01),且观察组治疗后较对照组下降更明显,差异有统计学意义(P<0.05);两组患者治疗后肺动脉收缩压显著降低,同治疗前比较差异有统计学意义(P<0.05),但治疗后两组差异无统计学意义(P>0.05)。两组患者治疗后右心室各结构参数显著改善,同治疗前比较差异具有统计学意义(P<0.05,<0.01),但治疗后两组组间比较差异无统计学意义(P>0.05)。pearson相关分析显示肺动脉收缩压同右心室各结构参数呈显著正相关(r=0.47~0.65),P<0.01)。结论长期无创机械通气可以明显降低肺心病患者肺动脉高压,改善右心室结构和功能。更多还原

【Abstract】 Objective To observe the clinical effects of long-term noninvasive mechanical ventilation on right ventricular structure and function disorder in end-stage cor pulmonale patients. Methods By case-control study,all patients were randomly divided into observation group and control group. Based on regular treatment,pulmonary arterial systolic pressure,structural parameters of right ventricle( RVOT,RVD,RVWT,RPA and LV / RV) and pro-BNP were evaluated in the observation group before and after one year of using long-term noninvasive mechanical ventilation. Results Pro-BNP reduced after treatment,and there was a significant difference( P < 0. 01),compared with that before treatment; the index in the observation group had a great decrease compared with control group,there was a significant difference( P < 0. 05). There was a significant reduction of pulmonary arterial systolic pressure of all patients after the treatment,compared with that before treatment( P <0. 05). However,there were no significant differences between the two groups after treatment( P > 0. 05). The structural parameters of right ventricle of all patients after treatment had a great improvement,and there was a significant difference compared with that before treatment( P < 0. 05; < 0. 01). However,there were no significant differences between two groups after treatment( P > 0. 05). Pearson correlation analysis showed the pulmonary arterial systolic pressure and structural parameters of right ventricle had significant positive correlation( r = 0. 47 ~ 0. 65,P < 0. 01). Conclusions Long-term noninvasive mechanical ventilation can reduce pulmonary arterial hypertension and improve right ventricular structure and function.更多还原