CAJ | 학술논문

目的探讨N-末端B型利钠肽原(N-terminal pro-B-type natriuretie peptide,NT-proBNP)预测外科重症监护室(surgical intensive care unit,SICU)预后的价值及其相关影响因素.方法分析入住SICU危重患者136例,收集相关的临床资料,分别检验血中NT-proBNP水平 ;根据住院30 d死亡情况分为死亡组与出SICU组,并比较和用多变量回归分析患者入SICU时NT-proBNP水平与各因素的相关性.结果死亡组(3.24±0.60)和出SICU组(2.93±0.65)的NT-proBNP差异有统计学意义(P=0.021).与NT-proBNP显著相关的因素依次为:美国纽约心脏病学会(the United States of New York Heart Association,NYHA)心功能分级、年龄、肾功能 ;其他如性别、血红蛋白、急性生理及慢性健康状况评分Ⅱ(acute physiology and chronic healthy evaluationⅡ,APACHEⅡ)、手术方式以及是否脓毒症或高血压在多变量回归分析中不能体现.结论 NT-proBNP对外科危重患者能否转出SICU有很好的预测价值,且其与心功能分级、年龄、肾功能密切相关,故在用NT-proBNP判断危重患者病情及预后时需综合考虑上述因素的影响.
목적 탐토N-말단B형리납태원(N-terminal pro-B-type natriuretie peptide,NT-proBNP)예측외과중증감호실(surgical intensive care unit,SICU)예후적개치급기상관영향인소.방법 분석입주SICU위중환자136례,수집상관적림상자료,분별검험혈중NT-proBNP수평 ;근거주원30 d사망정황분위사망조여출SICU조,병비교화용다변량회귀분석환자입SICU시NT-proBNP수평여각인소적상관성.결과 사망조(3.24±0.60)화출SICU조(2.93±0.65)적NT-proBNP차이유통계학의의(P=0.021).여NT-proBNP현저상관적인소의차위:미국뉴약심장병학회(the United States of New York Heart Association,NYHA)심공능분급、년령、신공능 ;기타여성별、혈홍단백、급성생리급만성건강상황평분Ⅱ(acute physiology and chronic healthy evaluationⅡ,APACHEⅡ)、수술방식이급시부농독증혹고혈압재다변량회귀분석중불능체현.결론 NT-proBNP대외과위중환자능부전출SICU유흔호적예측개치,차기여심공능분급、년령、신공능밀절상관,고재용NT-proBNP판단위중환자병정급예후시수종합고필상술인소적영향.
Objective To evaluate predictive value of N-terminal pro-B-type natriuretie peptide (NT-proBNP) on the prognosis of critically ill patients in surgical intensive care unit (SICU) and its possible influential factors.Methods The level of NT-proBNP in blood was measured and the clinical data was collected in 136 critically ill patients who were admitted in SICU.The patients were divided into death group and survival group according to 30 d mortality.The level of NT-proBNP was compared between death group and survival group and analyzed with the clinical factors by multiple regression analysis.Results There was statistically different in NT-proBNP between the death group(3.24±0.60) and survival group(2.93±0.65)(P=0.021).Multiple regression analysis showed that NYHA classification of cardiac function,age,and renal function were significantly related to NT-proBNP,but gender,hemoglobin,acute physiology and chronic healthy evaluation Ⅱ score (APACHE Ⅱ),surgical approach,and the state of sepsis or hypertension in the multiple regression analysis did not showed any significant.Conclusions The level of NT-proBNP had a good predictive value on the prognosis of critically ill patients in SICU,and was significantly associated with NYHA classification of cardiac function,age,renal function.So these factors should be taken into account when NT-proBNP was used to predict the prognosis of the critically ill patients.