氨基末端脑利钠肽前体水平对非HIV免疫损害患者肺炎的预后价值

目的 评价氨基末端脑利钠肽前体（N-terminal pro-brain natriuretic peptide，NT-proBNP） 水平对非HIV 免疫损害患者肺炎预后的预测作用。 方法 回顾性研究本院呼吸重症监护病房（respiratory intensive care unit，RICU）2011 年1 月- 2013 年5 月收治的非HIV 免疫损害患者肺炎的临床资料。收集入RICU 24 h 内的NT-proBNP 测定值。根据ICU 生存情况，分为死亡组和存活组，比较两组间NT-proBNP、APACHE Ⅱ评分的差异。 结果 本研究入选患者44 例，死亡18 例，存活26 例。死亡组的NT-proBNP 水平（ 中位数3 066.5 pg/ml） 显著高于存活组（ 中位数372.0 pg/ml）。NT-proBNP 和APACHE Ⅱ评分预测ICU 病死率的受试者工作曲线下面积分别为0.707（95％置信区间[0.552，0.862]） 和0.841（95％置信区间[0.712，0.961]）。 结论 氨基末端脑利钠肽前体水平升高提示预后差，其对非HIV 免疫损害患者肺炎的预后价值仍需进一步研究。

Role of N-terminal pro-brain natriuretic peptide level in predicting prognosis of pneumonia in non-HIV immunocompromised patients

Objective To study the role of N-terminal pro-brain natriuretic peptide （NT-proBNP） level in predicting the prognosis of pneumonia in non-HIV immunocompromised patients. Methods Clinical data about pneumonia in non-HIV immunocompromised patients admitted to respiratory intensive care unit（RICU） in our hospital from January 2011 to May 2013 were retrospectively analyzed. The NT-proBNP level in non-HIV immunocompromised patients was measured within 24 h after admission. The patients were divided into death group and survival group according to their mortality in RICU. The NT-proBNP and APACHE Ⅱ scores were compared between the 2 groups. Results Of the 44 patients included in this study, 18 died and 26 survived. The NT-proBNP level was significantly higher in death group than in survival group （3 066.5 pg/ml vs 372.0 pg/ml）. The area under the ROC curves for the mortality in RICU as predicted with the NT-proBNP and APACHE Ⅱ scores was 0.707 （95% CI： 0.552, 0.862） and 0.841（95% CI： 0.712, 0.961） , respectively. Conclusion Elevated NT-proBNP level indicate a poor prognosis of pneumonia in non- HIV immunocompromised patients. Its value in predicting the prognosis of pneumonia in non-HIV immunocompromised patients needs to be further studied.