CAJ | 학술논문

目的：观察脑钠肽（ BNP）在严重脓毒症合并心肌损伤患者在机械通气脱机过程中的预测作用。方法：回顾性分析急诊ICU住院严重脓毒症机械通气患者病例资料，123例患者根据首次脱机情况分为脱机成功组与脱机失败组，采用受试者工作特征（ ROC）曲线分析两组患者脱机前血气分析结果及BNP水平与脱机之间的关系。结果：123例患者，一次脱机拔管成功89例，失败34例。脱机前两组动脉血氧分压（ PO2）、二氧化碳分压（ PCO2）及血清BNP比较：成功组PO2较失败组高，而PCO2及BNP水平则较失败组明显下降，组间比较三者差异均有统计学意义（ P﹤0.05）。通过ROC曲线计算动脉血PO2、PCO2及血清BNP曲线下面积（ AUC）分别为0.655，0.709，0.874。Youden指数最大的是BNP，其对应的脱机成功的敏感性89.89%，特异性为76.47%。结论：严重脓毒症合并心肌损伤的机械通气患者脱机过程中，BNP水平对预测拔管成功的价值较血气分析要高。
목적：관찰뇌납태（ BNP）재엄중농독증합병심기손상환자재궤계통기탈궤과정중적예측작용。방법：회고성분석급진ICU주원엄중농독증궤계통기환자병례자료，123례환자근거수차탈궤정황분위탈궤성공조여탈궤실패조，채용수시자공작특정（ ROC）곡선분석량조환자탈궤전혈기분석결과급BNP수평여탈궤지간적관계。결과：123례환자，일차탈궤발관성공89례，실패34례。탈궤전량조동맥혈양분압（ PO2）、이양화탄분압（ PCO2）급혈청BNP비교：성공조PO2교실패조고，이PCO2급BNP수평칙교실패조명현하강，조간비교삼자차이균유통계학의의（ P﹤0.05）。통과ROC곡선계산동맥혈PO2、PCO2급혈청BNP곡선하면적（ AUC）분별위0.655，0.709，0.874。Youden지수최대적시BNP，기대응적탈궤성공적민감성89.89%，특이성위76.47%。결론：엄중농독증합병심기손상적궤계통기환자탈궤과정중，BNP수평대예측발관성공적개치교혈기분석요고。
Objective To evaluate the predictive effect of B-type natriuretic peptides( BNP)in the process of extubation at severe sep-sis patients with cardiac injury. Method Retrospective analyse the extubation in severe sepsis patients with cardiac injury who need me-chanical ventilation at EICU. 123 patients were divided into success group and failed according to extubation after the first spontaneous breathe trial( SBT). Receive operating characteristic( ROC)curves was used to analyses the relationship among blood gas analysis,BNP and extubation. Results There were 89 patients extubate successful after the first SBT and 34 failed. A significant difference was noted in PO2 , PCO2 and BNP between the two groups(P ﹤0. 05). The area under the curve(AUC)of PO2,PCO2 and BNP were 0. 655,0. 709 and 0. 874,respectively. BNP had the maximum Youden index with a sensitivity of 86. 8% and specificity of 89. 89%. Conclusion The level of BNP is a more valuable predictor for extubation in severe sepsis with cardiac injury than PO2 and PCO2 .