中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
9期
938-941
,共4页
钱安瑜%张茂%巴立%干建新
錢安瑜%張茂%巴立%榦建新
전안유%장무%파립%간건신
多处创伤%N末端B型利钠肽原%预后
多處創傷%N末耑B型利鈉肽原%預後
다처창상%N말단B형리납태원%예후
Multiple trauma%N-terminal pro-B-type natriuretic peptide%Prognosis
目的 观察严重创伤后N末端B型利钠肽原(NT-proBNP)水平的动态变化及与预后的关系. 方法 检测60例严重创伤患者伤后1,3,7d血清NT-proBNP.根据患者预后,分为生存组和死亡组,分别观察两组NT-proBNP水平变化,比较两组NT-proBNP水平差异.分析不同时相点NT-proBNP水平与相应急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)以及ISS的相关性,通过受试者工作特征曲线(receiver operating characteristic curve,ROC)分析各时相点NT-proBNP对预后的判断价值. 结果 60例严重创伤患者1,3,7d的NT-proBNP整体水平差异无统计学意义,处于正常参考范围内.死亡组各时相点NT-proBNP水平均高于生存组.死亡组7 dNT-proBNP较1d明显升高;生存组NT-proBNP水平呈现先升高后降低的趋势,7d较3d降低.各时相点NT-proBNP水平判断预后的ROC曲线下面积与APACHEⅡ、ISS比较差异无统计学意义. 结论 严重创伤后NT-proBNP水平明显或持续升高提示预后不良,NT-proBNP可作为严重创伤救治中病情评估的参考指标进行动态观察.
目的 觀察嚴重創傷後N末耑B型利鈉肽原(NT-proBNP)水平的動態變化及與預後的關繫. 方法 檢測60例嚴重創傷患者傷後1,3,7d血清NT-proBNP.根據患者預後,分為生存組和死亡組,分彆觀察兩組NT-proBNP水平變化,比較兩組NT-proBNP水平差異.分析不同時相點NT-proBNP水平與相應急性生理與慢性健康評分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)以及ISS的相關性,通過受試者工作特徵麯線(receiver operating characteristic curve,ROC)分析各時相點NT-proBNP對預後的判斷價值. 結果 60例嚴重創傷患者1,3,7d的NT-proBNP整體水平差異無統計學意義,處于正常參攷範圍內.死亡組各時相點NT-proBNP水平均高于生存組.死亡組7 dNT-proBNP較1d明顯升高;生存組NT-proBNP水平呈現先升高後降低的趨勢,7d較3d降低.各時相點NT-proBNP水平判斷預後的ROC麯線下麵積與APACHEⅡ、ISS比較差異無統計學意義. 結論 嚴重創傷後NT-proBNP水平明顯或持續升高提示預後不良,NT-proBNP可作為嚴重創傷救治中病情評估的參攷指標進行動態觀察.
목적 관찰엄중창상후N말단B형리납태원(NT-proBNP)수평적동태변화급여예후적관계. 방법 검측60례엄중창상환자상후1,3,7d혈청NT-proBNP.근거환자예후,분위생존조화사망조,분별관찰량조NT-proBNP수평변화,비교량조NT-proBNP수평차이.분석불동시상점NT-proBNP수평여상응급성생리여만성건강평분Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)이급ISS적상관성,통과수시자공작특정곡선(receiver operating characteristic curve,ROC)분석각시상점NT-proBNP대예후적판단개치. 결과 60례엄중창상환자1,3,7d적NT-proBNP정체수평차이무통계학의의,처우정상삼고범위내.사망조각시상점NT-proBNP수평균고우생존조.사망조7 dNT-proBNP교1d명현승고;생존조NT-proBNP수평정현선승고후강저적추세,7d교3d강저.각시상점NT-proBNP수평판단예후적ROC곡선하면적여APACHEⅡ、ISS비교차이무통계학의의. 결론 엄중창상후NT-proBNP수평명현혹지속승고제시예후불량,NT-proBNP가작위엄중창상구치중병정평고적삼고지표진행동태관찰.
Objective To detect the dynamic change of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with major trauma and measure its relation to the outcome.Methods Sixty patients with major trauma were measured with serum NT-proBNP level at 1,3,and 7 days postinjury.According to the prognosis,the patients were allocated to survival group (n =47) and death group (n =13).Changes in NT-proBNP was detected and compared between the two groups.Correlation of NT-proBNP level with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and ISS was analyzed at each time point.Receiver operating characteristic curve (ROC) was developed to determine the prognostic value of NT-proBNP.Results Overall NT-proBNP level revealed no statistical difference at each time point and kept within normal reference range.NT-proBNP level in death group increased gradually,whereas in survival group the increase was followed by a reduction.Moreover,NT-proBNP level was higher in death group than in survival group at each time point.Area under the ROC of NT-proBNP had no statistical difference with that of APACHE Ⅱ and ISS at each time point.Conclusions Obviously high or continuously increased NT-proBNP level may indicate an unfavorable prognosis of major trauma patients.NT-proBNP can be used as a marker to dynamically predict prognosis of major trauma patients.
