血浆N末端脑型利钠肽前体对危重症患者预后的评估价值

目的探讨血浆N末端脑型利钠肽前体(NT-proBNP)水平在评价危重症患者预后中的价值。方法139例危重症患者入ICU即测定血浆NT-proBNP水平,并在24h内进行APACHEⅡ评分,记录血浆NT-proBNP水平与APACHEⅡ评分、危重症患者的存活、ICU住院时间等主要的预后指标,并进行分析。结果存活者血浆NT-proBNP水平为(993.49±1082.38)pg/ml,低于死亡者的(2518.85±2106.41)pg/ml,差异有统计学意义(P<0.0001)。A组(NT-proBNP水平>900pg/ml)APACHEⅡ评分低于B组(NT-proBNP水平≤900pg/ml),ICU住院天数短于B组,病死率低于B组,差异均有统计学意义(P<0.001)。血浆NT-proBNP水平的曲线下面积AUROCC为0.764,其与A-PACHEⅡ评分之间呈显著正相关(r=0.421,P=0.005)。结论血浆NT-proBNP水平对危重症患者的病死率、ICU住院时间等预后指标具有预测价值,其与APACHEⅡ评分呈显著正相关。

The evaluating effect of serum N terminating pro-Brain Natriuretic Peptide on prognosis of critical patients

Objective To search the evaluating effect of serum N terminating pro-Brain Natriuretic Peptide （NT- proBNP） on prognosis of critical patients. Methods The NT-proBNP level of 139 patients was examined when they were ad- mitted in intensive care unit （ICU）. The APACHE II score was evaluated in 24 hours. Serum NT-proBNP,APACHE II score, death,length of ICU stay were recorded and analyzed. Results The NT-proBNP level of survivors was （993.49 ＋ 1082.38 ） pg/ml,which was lower than （2518.85 ~ 2106.41 ） pg/ml of the dead, and the difference was statistically significant （P 〈 0. 0001 ）. The APACHE II score of group A （ NT-proBNP level 〉 900pg/ml） was lower than that of group B （ NT-proBNP lev- el ~ 900pg/ml） ; the length of ICU stay of group A was shorter than that of group B; the mortality of group A was lower than that of group B, the difference were statistically significant （ P 〈 0.001 ）. And the area under ROC curve （AUROCC） of serum NT- proBNP level was 0.764, which was positive correlation with APACHE II score （ r = 0.421, P = 0.005 ）. Conclusion Serum NT-proBNP level was valuable of predicting mortality and ICU stay of critical care patients, and which was positive correlation with APACHE II score.