BNP联合APACHE Ⅱ评分在危重病患者预后评价中的意义

目的: 探讨B型钠尿肽(BNP)水平联合急性生理和慢性健康状况评分Ⅱ(APACHE Ⅱ)在评价危重病患者预后中的意义。方法: 对2009年10月至2010年2月期间进入暨南大学附属第一医院中心ICU病房的62例危重症患者在24 h内进行APACHE Ⅱ评分及测定血清BNP水平,分析两者与危重症患者的病死率、住院时间、机械通气的发生率及通气时间等主要预后指标的关系。结果: 62例患者存活44例,死亡18例,病死率为29.0%。其中死亡组APACHE Ⅱ评分值和血清BNP浓度均明显高于存活组(P<0.01)。APACHE Ⅱ评分、呼吸机使用率及病死率随BNP水平升高而升高。结论: BNP和APACHE Ⅱ评分的升高对危重症患者的存活、机械通气的发生率及通气时间、住院时间等主要预后指标的预测有重要意义。

Significance of BNP and APACHE II score on prognosis assessment of critically ill patients

AIM: To evaluate the role of plasma B-type natriuretic peptide(BNP) level and the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) in the prognosis assessment of critically ill patients.METHODS: Sixty-two critically-ill patients in ICU fo the First Affiliated Hospital of Jinan University were enrolled from October 2009 to February 2010.The APACHE II score was calculated and plasma BNP level was measured within the first 24 h after admission.The correlations between BNP/APACHE Ⅱ score and length of hospitalization,rate of mechanical ventilation application,duration of ventilation and fatality rate were analyzed. RESULTS: There were 44 survivals and 18 deaths in 62 admissions.The average APACHE II score and plasma BNP level in the survival group were higher than those in death group(P<0.01).Sixty-two patients were divided into 3 groups according to their APACHE Ⅱ scores.With increased BNP level,APACHE II score,rate of mechanical ventilation application and fatality rate were also increased.CONCLUSION: The increasing level of BNP and APACHE Ⅱ score have significant implications in prognosis assessment of survival rate,rate of mechanical ventilation application,duration of ventilation and length of hospitalization in critically ill patients.