检测PA、NT—proBNP在高龄急性脑梗死并发老年多器官功能不全综合征中的意义

目的探讨血清前白蛋白（PA）和血清氨基末端脑钠肽前体（NT—proBNP）在高龄急性脑梗死并发老年多器官功能不全综合征（MODSE）患者中的变化及与预后的关系。方法61例高龄急性脑梗死并发MODSE患者诊断当日行急性生理学慢性健康状况评分（APACHEⅡ评分），并于次日抽血测定空腹血清PA、NT—proBNP水平。按患者APACHEII评分值将患者分为3组（A组10～15分，B组16～20分和c组〉20分），分析3组患者的空腹血清PA、NT—proBNP水平及死亡率；再根据疾病转归将患者分为生存组和死亡组，分析两组患者的空腹血清PA、NT—proBNP水平和APACHEⅡ评分值。结果A组空腹血清PA检测水平明显高于B、C组（P〈0．05），B组明显高于C组（P〈0．05）；血清NT—proBNP数值A组空腹水平明显低于B、C组（P〈0．05），B组明显低于C组（P〈0．05）；死亡率A组低于B、C组，B组低于C组。死亡组APACHEII评分值较生存组高（P〈0．01），空腹血清PA水平较生存组低（P〈0．05），NT—proBNP水平较生存组高（P〈0．01）。结论联合检测空腹血清PA、NT—proBNP水平对评估高龄急性脑梗死并发老年多器官功能不全综合征患者的病情和预后具有一定的临床意义，其NT—proBNP水平越高、血清PA水平越低者，病情越重，死亡率越高。

The Clinical significance of joint detection of serum prealbumin and N - terminal probrain natriuretic eptide in mul- tiple organ dysfunction syndrome elderly after Acute cerebral infarction

Objective To investigate the changes of serumprealbumin and N - terminal probrain natriuretic eptide in multiple organ dysfunction syndrome in elderly after Acute cerebral infarction. Methods Sixty - one elderly patients with multiple organ dysfunction after Acute cerebral infarction were enrolled. The severity of illness score（ APACHE Ⅱ score）was determined during the first 24 h in the hospital. At the same time, the levels of serum NT - proBNP and Serum prealbumin were measured. All patients were divided into three group according to the severity of illness score （ APACHE II score）. （ group A ： 10 - 15 ; group B ： 16 - 20 ; group C ： 〉 20）. According to the results of I month follow - up, the patients were di- vided into survival group （ n = 43 ） and death group （ n = 18 ）. Results Serum prealbumin level in survival group patients was higher than the death group, and the difference between the two groups was obvious （ P 〈 0.05 ）. Serum prealbumin level in group A patients was higher than the group B, C, group B patients was higher than the groupC （ P 〈 0. 05 ）. N - terminal pro- brain natriuretic eptide level in death group patients was higher than the survival group, and there was significant difference be-tween the two groups （ P 〈 0.01 ）. N - terminal probrain natriuretic eptide level in groupA patients was lower than the groupB ,C, groupB patients was lower than the group C （P 〈 0.05 ）. The severity of illness score （APACHE II score） in death group patients was higher than the survival group, and there was significant difference between the two groups （P 〈0. 01 ）. Conclusion The joint detection is a sensitiveindex in the evaluation of multiple organ dysfunction syndrome in elderly after acute cerebrovascular disease of patients.