Abstract: Objective: To evaluate the influences of ventilator assisted ventilation on plasma level of D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) 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-proBNP level, with SpO₂ and oxygenation index (OI) before, 7d 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 SpO₂ and OI of children in 2 groups after treatment were obviously higher than that before treatment, plasma D-dimer and NT-proBNP 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-proBNP level of ALI children were negatively correlated to OI (r=-0.796, -0.651, P<0.05). Conclusions: Plasma D-dimer and NT-proBNP 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-proBNP level.

Key words: Children, Acute lung injury, N-terminal pro-brain natriuretic peptide, D-dimer, Ventilator assisted ventilation

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(SpO₂)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、SpO₂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。

关键词: 小儿, 急性肺损伤, 氨基末端脑钠肽前体, D-二聚体, 呼吸机辅助通气