CAJ | 학술논문

目的：评价 N 端 B 型脑钠肽前体（NT-proBNP)对脓毒症患者预后评估的临床价值。方法选取2011年1月—2013年6月我院重症医学科收治的60例脓毒症,按患者入院28 d 后的生存情况分为生存组42例和死亡组18例,比较两组入院2 h 内 NT-proBNP 水平及入院24 h 内急性生理学与慢性健康状态评价系统Ⅱ（acute physiology and chronichealth evaluation, APACHE Ⅱ)评分,通过建立受试者工作特征（ROC)曲线探讨 NT-proBNP 对脓毒症患者预后评估的价值。结果入院2 h 内,死亡组 NT-proBNP 水平为（5873．24±1768．37) pg/ ml 明显高于生存组的（2170．45±625．28)pg/ ml,差异有统计学意义（t =2．660,P =0．015)；死亡组 APACHE Ⅱ评分为（26．47±5．32)分,也明显高于生存组的（21．54±4．35)分,差异有统计学意义（t =2．390,P =0．020)。 Pearson 相关性分析显示,NT-proBNP与 APACHE Ⅱ评分呈正相关（r =0．509,P =0．003)。 NT-proBNP 水平和 APACHE Ⅱ评分的 ROC 曲线下面积分别为0．730和0．715,两者评估预后效能相仿。结论 NT-proBNP 对脓毒症患者预后评估有较好的临床价值,可作为脓毒症患者预后判断的一个参考指标。
목적：평개 N 단 B 형뇌납태전체（NT-proBNP)대농독증환자예후평고적림상개치。방법선취2011년1월—2013년6월아원중증의학과수치적60례농독증,안환자입원28 d 후적생존정황분위생존조42례화사망조18례,비교량조입원2 h 내 NT-proBNP 수평급입원24 h 내급성생이학여만성건강상태평개계통Ⅱ（acute physiology and chronichealth evaluation, APACHE Ⅱ)평분,통과건립수시자공작특정（ROC)곡선탐토 NT-proBNP 대농독증환자예후평고적개치。결과입원2 h 내,사망조 NT-proBNP 수평위（5873．24±1768．37) pg/ ml 명현고우생존조적（2170．45±625．28)pg/ ml,차이유통계학의의（t =2．660,P =0．015)；사망조 APACHE Ⅱ평분위（26．47±5．32)분,야명현고우생존조적（21．54±4．35)분,차이유통계학의의（t =2．390,P =0．020)。 Pearson 상관성분석현시,NT-proBNP여 APACHE Ⅱ평분정정상관（r =0．509,P =0．003)。 NT-proBNP 수평화 APACHE Ⅱ평분적 ROC 곡선하면적분별위0．730화0．715,량자평고예후효능상방。결론 NT-proBNP 대농독증환자예후평고유교호적림상개치,가작위농독증환자예후판단적일개삼고지표。
Objective To evaluate the prognosis value of immunoreactive amino-terminal pro-brain natriuretic peptide (NT-proBNP) on patients with sepsis. Methods A total of 60 sepsis patients admitted during January 2011 and June 2013 were divided into survival group (n = 42) and death group (n = 18) based on the survival status on the 28th d after admission. Serum NT-proBNP levels within 2 h after admission and APACHE II (acute physiology and chronic health evaluation II) scores within 24 h after admission in the two groups were compared, and the value of NT-proBNP on prognostic assessment of sepsis patients were investigated by establishment of the ROC curve of work characteristics. Results The serum level of NT-proBNP in death group (5873. 24 ± 1768. 37)pg/ ml was significant higher than (2170. 45 ± 625. 28) pg/ ml in the survival group, and the difference was statistically significant (t = 2. 660, P = 0. 015); APECHE II score of (26. 47 ± 5. 32) in death group was significantly higher than (21. 54 ± 4. 35)in survival group, and the difference was also statistically significant (t =2. 390, P = 0. 020). Pearson correlation analysis indicated that the serum NT-proBNP level had a positive correlation with APACHE II score (r = 0. 509, P = 0. 003). The area under the ROC curve for NT-proBNP level and APACHE II score were 0. 730 and 0. 715 respectively, which had a similar prognosis assessment value in sepsis patients. Conclusion NT-proBNP has a better clinical value on the prognosis assessment of sepsis patients, and can be served as a reference index for the prog-nosis evaluation in sepsis patients.