呼吸机辅助通气对ALI患儿血浆D-dimer、NT-proBNP水平的影响
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摘要
目的:评价呼吸机辅助通气对急性肺损伤(ALI)患儿血浆D-二聚体(D-dimer)和氨基末端脑钠肽前体(NT-proBNP)水平的影响。方法:60例ALI患儿随机分为观察组和对照组,每组各30例,对照组患儿给予常规治疗,观察组患儿在常规治疗的基础上给予呼吸机辅助通气。分别记录两组患儿治疗前、治疗7d时血浆D-dimer和NT-proBNP水平,以及血氧饱和度(SpO_2)和氧合指数(OI),分析血浆D-dimer、NT-proBNP水平与OI的相关性;并于治疗7d时评价疗效。结果:治疗7d时,观察组治疗总有效率为93.33%(28/30),明显高于对照组(73.33%,P<0.05)。治疗后,两组患儿的OI、SpO_2明显高于治疗前,D-dimer、NT-proBNP明显低于治疗前(P<0.05);并且,观察组治疗后各指标的改善情况明显优于对照组治疗后(P<0.05)。ALI患儿血浆D-dimer、NT-proBNP水平与OI呈负相关关系(r=-0.796、-0.651,P<0.05)。结论:血浆NT-proBNP、D-dimer水平与ALI患儿病情密切相关;呼吸机辅助通气治疗小儿ALI可显著提高治疗效果,可能与降低血浆D-dimer、NT-proBNP水平有关。
Objective:To evaluate the influences of ventilator assisted ventilation on plasma level of D-dimer and N-terminal pro-brain natriuretic peptide(NT-pro BNP) in children with acute lung injury(ALI). Methods: 60 ALI children were randomly divided into observation group and control group with 30 children in each group. The children in control group were treated with conventional therapy, the children in observation group were also given ventilator assisted ventilation on the basis of conventional therapy. The plasma D-dimer and NT-pro BNP level, with SpO_2 and oxygenation index(OI) before, 7 d after treatment of children in 2 groups were recorded; as well as the curative effects after 7-day treatment were evaluated. Results: The total effective rate of observation group was 93.33%(28/30), which was obviously higher than control group(73.33%, P<0.05). The SpO_2 and OI of children in 2 groups after treatment were obviously higher than that before treatment, plasma D-dimer and NT-pro BNP level after treatment were obviously lower(P<0.05). Moreover, the improvement of aboving indexes of ALI children in observation group were obviously better than control group(P<0.05). The plasma D-dimer and NT-pro BNP level of ALI children were negatively correlated to OI(r=-0.796,-0.651, P<0.05). Conclusions: Plasma D-dimer and NT-pro BNP level were closely correlated with the severity of ALI children. Ventilator assisted ventilation can significantly improve the therapeutic effect of ALI children, which may be related to decrease plasma D-dimer and NT-pro BNP level.
Objective:To evaluate the influences of ventilator assisted ventilation on plasma level of D-dimer and N-terminal pro-brain natriuretic peptide(NT-pro BNP) in children with acute lung injury(ALI). Methods: 60 ALI children were randomly divided into observation group and control group with 30 children in each group. The children in control group were treated with conventional therapy, the children in observation group were also given ventilator assisted ventilation on the basis of conventional therapy. The plasma D-dimer and NT-pro BNP level, with SpO_2 and oxygenation index(OI) before, 7 d after treatment of children in 2 groups were recorded; as well as the curative effects after 7-day treatment were evaluated. Results: The total effective rate of observation group was 93.33%(28/30), which was obviously higher than control group(73.33%, P<0.05). The SpO_2 and OI of children in 2 groups after treatment were obviously higher than that before treatment, plasma D-dimer and NT-pro BNP level after treatment were obviously lower(P<0.05). Moreover, the improvement of aboving indexes of ALI children in observation group were obviously better than control group(P<0.05). The plasma D-dimer and NT-pro BNP level of ALI children were negatively correlated to OI(r=-0.796,-0.651, P<0.05). Conclusions: Plasma D-dimer and NT-pro BNP level were closely correlated with the severity of ALI children. Ventilator assisted ventilation can significantly improve the therapeutic effect of ALI children, which may be related to decrease plasma D-dimer and NT-pro BNP level.
引文
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[3]中华医学会呼吸病学分会.急性肺损伤/急性呼吸窘迫综合征的诊断标准(草案)[J].现代实用医学,2002,1(43):161.
[4]Malle E,Sodin-Semrl S,Kovacevic A.Serum amyloid A:anacute-phase protein involved in tumour pathogenesis[J].Cell Moi Life Sci,2009,66(1):9-26.
[5]阿不来提·海里力,木拉提别克·斯地克,刘宇.急性呼吸窘迫综合征对凝血纤溶系统的影响[J].医学前沿,2012,2(1):391-392.
[6]Jasayeri JA,Carroll GJ,Vemallis AB.Interleukin-6 subfamily eytokines and rheumatoid arthritis:Role of antagonists[J].Int Immunophammcol,2010,10(1):1-8.
[7]谢衬梨.生长素释放肽对CLP小鼠介导ALI的保护作用与相关信号转导机制[D].广州:广州医学院,2009.
[8]李飞,袁勇,张励庭,等.NT-proB NP在急性肺损伤的诊断及预后评价中的应用价值[J].亚太传统医药,2009,5(7):107-109.