目的　 评价无创性双水平正压机械通气 (BNIV )在老年急性心源性肺水肿 (ACPE)病人中的可行性、安全性及其疗效。　 方法 　将 48例ACPE老年患者随机分为常规药物治疗组和BNIV +药物治疗组 (简称为BNIV组 ) ,观察 2组患者开始治疗后 0 5h、1h、2h、3dNYHA心功能分级指标和住院期间的病死率等。　 结果　BNIV组患者的心功能NYHA分级指数在开始治疗后 0 5、1、2h及住院期间的病死率明显优于常规治疗组 (P <0 0 5 ) ;3d时的NYHA分级在 2组之间无显著性差异 (P >0 0 5 ) ;且BNIV治疗无严重并发症发生。　 结论 　BNIV在辅助药物治疗老年性ACPE中可明显加快病情的改善 ,提高早期治疗成功率 ,降低住院期间病死率。 Objective To evaluate the feasibility, safety and efficacy of noninvasive bi-level positive pressure mechanical ventilation (BNIV) in elderly patients with acute cardiogenic pulmonary edema (ACPE). Methods Forty-eight elderly patients with ACPE were randomly divided into conventional drug treatment group and BNIV + drug treatment group (BNIV group for short). The cardiac function grading index at 0-5h, 1h, 2h and 3d, Fatality rate and so on. Results The NYHA classification index of heart function in BNIV group was significantly better than that of routine treatment group at 0, 5, 1, 2 hours and hospitalization (P <0 05). NYHA classification at 3 days was between 2 groups No significant difference (P> 0.05); and BNIV treatment without serious complications. Conclusions BNIV can significantly improve the condition, improve the success rate of early treatment and reduce the mortality during hospitalization in adjuvant drug treatment of senile ACPE.