中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
28期
16-19
,共4页
C反应蛋白质%预后%氨基端B型钠尿肽前体%D-二聚体
C反應蛋白質%預後%氨基耑B型鈉尿肽前體%D-二聚體
C반응단백질%예후%안기단B형납뇨태전체%D-이취체
C-reactive protein%Prognosis%N-terminal pro-B-type natriuretic peptide%D-dimer
目的 探讨血浆氨基端B型钠尿肽前体(NT-proBNP)、D-二聚体(D-D)和C反应蛋白(CRP)水平对老年卧床患者的预后评估作用.方法 回顾性分析150例老年卧床患者的临床资料,入院28 d内死亡35例(死亡组),存活115例(存活组).检测两组入院第1天(治疗前)、住院治疗中期(治疗中)及离院或死亡前1 d(治疗后)的血浆NT-proBNP、D-D和CRP水平,分析各指标的变化特征及对临床结局的预测价值.结果 死亡组治疗前、中、后NT-proBNP、D-D和CRP水平均显著高于存活组(P＜ 0.05或＜0.01),死亡组上述指标峰值出现在治疗后,存活组峰值出现在治疗前.2、3个标志物阳性在死亡组所占的比例分别为37.1％(13/35)、54.3％(19/35),明显高于存活组的20.9％(24/115)、8.7％(10/115),差异有统计学意义(P=0.032、0.008).非条件Logistic回归分析显示,治疗后NT-pwBNP、CRP、D-D水平是影响患者28 d病死率的危险因素(P＜0.05).结论 重症老年卧床患者的血浆NT-proBNP、D-D和CRP水平明显升高.这些标志物数值随着治疗进程而产生动态变化,死亡前达到最高值.血浆NT-proBNP、D-D和CRP水平是老年卧床患者住院病死率的独立预测因素.如三者联合检测、动态观察,对预测住院期间病死率价值更高.
目的 探討血漿氨基耑B型鈉尿肽前體(NT-proBNP)、D-二聚體(D-D)和C反應蛋白(CRP)水平對老年臥床患者的預後評估作用.方法 迴顧性分析150例老年臥床患者的臨床資料,入院28 d內死亡35例(死亡組),存活115例(存活組).檢測兩組入院第1天(治療前)、住院治療中期(治療中)及離院或死亡前1 d(治療後)的血漿NT-proBNP、D-D和CRP水平,分析各指標的變化特徵及對臨床結跼的預測價值.結果 死亡組治療前、中、後NT-proBNP、D-D和CRP水平均顯著高于存活組(P＜ 0.05或＜0.01),死亡組上述指標峰值齣現在治療後,存活組峰值齣現在治療前.2、3箇標誌物暘性在死亡組所佔的比例分彆為37.1％(13/35)、54.3％(19/35),明顯高于存活組的20.9％(24/115)、8.7％(10/115),差異有統計學意義(P=0.032、0.008).非條件Logistic迴歸分析顯示,治療後NT-pwBNP、CRP、D-D水平是影響患者28 d病死率的危險因素(P＜0.05).結論 重癥老年臥床患者的血漿NT-proBNP、D-D和CRP水平明顯升高.這些標誌物數值隨著治療進程而產生動態變化,死亡前達到最高值.血漿NT-proBNP、D-D和CRP水平是老年臥床患者住院病死率的獨立預測因素.如三者聯閤檢測、動態觀察,對預測住院期間病死率價值更高.
목적 탐토혈장안기단B형납뇨태전체(NT-proBNP)、D-이취체(D-D)화C반응단백(CRP)수평대노년와상환자적예후평고작용.방법 회고성분석150례노년와상환자적림상자료,입원28 d내사망35례(사망조),존활115례(존활조).검측량조입원제1천(치료전)、주원치료중기(치료중)급리원혹사망전1 d(치료후)적혈장NT-proBNP、D-D화CRP수평,분석각지표적변화특정급대림상결국적예측개치.결과 사망조치료전、중、후NT-proBNP、D-D화CRP수평균현저고우존활조(P＜ 0.05혹＜0.01),사망조상술지표봉치출현재치료후,존활조봉치출현재치료전.2、3개표지물양성재사망조소점적비례분별위37.1％(13/35)、54.3％(19/35),명현고우존활조적20.9％(24/115)、8.7％(10/115),차이유통계학의의(P=0.032、0.008).비조건Logistic회귀분석현시,치료후NT-pwBNP、CRP、D-D수평시영향환자28 d병사솔적위험인소(P＜0.05).결론 중증노년와상환자적혈장NT-proBNP、D-D화CRP수평명현승고.저사표지물수치수착치료진정이산생동태변화,사망전체도최고치.혈장NT-proBNP、D-D화CRP수평시노년와상환자주원병사솔적독립예측인소.여삼자연합검측、동태관찰,대예측주원기간병사솔개치경고.
Objective To evaluate the value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP),C-reactive protein(CRP) and D-dimer(D-D) in prognosis of elderly patients confined to bed.Methods The clinical data of 150 elderly patients confined to bed were reviewed retrospectively,and 35 patients were in dead group and 115 patients were in survival group.The level o f plasma NT-proBNP,CRP and D-D were measured before treatment,during treatment and after treatment.Their characteristics and dynamic change were analyzed,and the value of NT-proBNP,CRP and D-D was evaluated in prognosis of elderly patients confined to bed.Results The level of NT-proBNP,D-D and CRP in dead group before treatment,during treatment and after treatment were significantly higher than those in survival group (P ＜ 0.05 or ＜ 0.01).The peak level of NT-proBNP,D-D and CRP in dead group emerged after treatment.By the way,the peak level of NT-proBNP,D-D and CRP in survival group emerged before treatment.Incidence of two or three markers positive in dead group [37.1％ (13/35),54.3％ (19/35)] was significantly greater than that in survival group [20.9％ (24/115),8.7％ (10/115)] (P =0.032,0.008).Multivariate Logistic regression analysis showed that the level of NT-proBNP,D-D and CRP were independent predictors of 28-day mortality (P ＜0.05).Conclusions The level of NT-proBNP,CRP and D-D are increased in severe elderly hospitalized patients.The level of above indexes have a dynamic change and reach peak before death.They are the independent prognostic markers of hospital mortality.Combined detection of NT-proBNP,D-D and CRP can improve the predictive value of hospital mortality in elderly patients confined to bed.
