CAJ | 학술논문

目的：研究升高的肌钙蛋白I和N-末端脑钠肽前体( NT-proBNP)水平对慢性阻塞性肺疾病急性加重期( AECOPD)患者近期预后的预测价值。方法210名AECOPD患者入院时进行动脉血气、社区获得性肺炎评分( CURB65评分)、C反应蛋白、体重指数、NT-proBNP及肌钙蛋白I测定,所有患者随访临床结局(存活和死亡),比较不同预后患者之间各指标的差异,评价这些指标与AECOPD预后的关系。结果 Logistic多因素分析显示,CURB65评分、血二氧化碳分压( PaCO2)、NT-proBNP和肌钙蛋白I水平与死亡率明显相关( P<0．05)。 NT-proBNP和肌钙蛋白I与死亡率有叠加关系：两者均升高组较正常组死亡率明显升高( P<0．001),NT-proBNP与肌钙蛋白I呈正相关( P<0．01)。结论肌钙蛋白I和NT-proBNP可作为判断AECO-PD近期预后的主要预测指标,并与其它的预后因子无关。两者联合检测对判断AECOPD近期预后有更好的预测价值。
목적：연구승고적기개단백I화N-말단뇌납태전체( NT-proBNP)수평대만성조새성폐질병급성가중기( AECOPD)환자근기예후적예측개치。방법210명AECOPD환자입원시진행동맥혈기、사구획득성폐염평분( CURB65평분)、C반응단백、체중지수、NT-proBNP급기개단백I측정,소유환자수방림상결국(존활화사망),비교불동예후환자지간각지표적차이,평개저사지표여AECOPD예후적관계。결과 Logistic다인소분석현시,CURB65평분、혈이양화탄분압( PaCO2)、NT-proBNP화기개단백I수평여사망솔명현상관( P<0．05)。 NT-proBNP화기개단백I여사망솔유첩가관계：량자균승고조교정상조사망솔명현승고( P<0．001),NT-proBNP여기개단백I정정상관( P<0．01)。결론기개단백I화NT-proBNP가작위판단AECO-PD근기예후적주요예측지표,병여기타적예후인자무관。량자연합검측대판단AECOPD근기예후유경호적예측개치。
Objective To evaluate the prognostic value of Troponin I and NT-proBNP for the recent prog-nosis in patients with AECOPD. Methods 210 patients with AECOPD were given arterial blood gas analysis, CURB65 scores, detection of C-reaction protein, body mass index, NT-proBNP and Troponin I. All patients were fol-lowed-up to compare the differences of each value between groups and evaluate the relationship between each value and prognosis in patients with AECOPD. Results The levels of PaCO2 , CURB65, Troponin I and NT-proBNP were obviously correlated with the death of AECOPD patient (all P<0. 05), which was reflected by Logistic multivariate analysis. NT-proBNP and troponin I levels appeared to have additive associations with mortality. Mortality among pa-tients with abnormalities of both NT-proBNP and troponin I was obviously higher than among patients with normal val-ues (P<0. 001). NT-proBNP and troponin I levels were positively correlated (P<0. 01). Conclusion NT-proB-NP and troponin I are strong predictors of early mortality among patients with AECOPD independent to other prognos-tic indicators. The joint detection has a better predictive value.