中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
2期
94-97,102
,共5页
张宝秋%宋其生%史剑权%吴恩东
張寶鞦%宋其生%史劍權%吳恩東
장보추%송기생%사검권%오은동
B型钠尿肽%N末端-前B型钠尿肽%重症监护病房%病死率%预后
B型鈉尿肽%N末耑-前B型鈉尿肽%重癥鑑護病房%病死率%預後
B형납뇨태%N말단-전B형납뇨태%중증감호병방%병사솔%예후
B-type natriuretic peptide%N-Terminal proBNP%Intensive care unit%Mortality%Prognosis
目的：研究N末端-前B型钠尿肽(NT-proBNP)水平动态变化对重症监护病房(ICU)患者死亡的预测价值。方法回顾性分析首都医科大学附属北京胸科医院ICU的58例死亡患者的临床资料，连续监测这些患者各个时间段NT-proBNP的数值，分析NT-proBNP及其变化值对患者预后的判断价值。用COX回归方法研究NT-proBNP及NT-proBNP变化值与死亡的相关性。结果 NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin与生存时间明显相关(P<0.05)，OR值结果分别为1.205(95%CI：1.201~1.208)、1.303(95%CI：1.298~1.307)、0.896(95%CI：0.893~0.898)。结论NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin可能是ICU患者死亡的预测因素，NT-proBNP 24、NT-proBNP 48 d与病死率呈正相关，NT-proBNPmin与病死率呈负相关。但是NT-proBNP结果必须结合临床环境来应用和解释，如何在更多混杂因素的环境下研究NT-proBNP对ICU患者预后的影响仍然需要更多的进一步研究。
目的：研究N末耑-前B型鈉尿肽(NT-proBNP)水平動態變化對重癥鑑護病房(ICU)患者死亡的預測價值。方法迴顧性分析首都醫科大學附屬北京胸科醫院ICU的58例死亡患者的臨床資料，連續鑑測這些患者各箇時間段NT-proBNP的數值，分析NT-proBNP及其變化值對患者預後的判斷價值。用COX迴歸方法研究NT-proBNP及NT-proBNP變化值與死亡的相關性。結果 NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin與生存時間明顯相關(P<0.05)，OR值結果分彆為1.205(95%CI：1.201~1.208)、1.303(95%CI：1.298~1.307)、0.896(95%CI：0.893~0.898)。結論NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin可能是ICU患者死亡的預測因素，NT-proBNP 24、NT-proBNP 48 d與病死率呈正相關，NT-proBNPmin與病死率呈負相關。但是NT-proBNP結果必鬚結閤臨床環境來應用和解釋，如何在更多混雜因素的環境下研究NT-proBNP對ICU患者預後的影響仍然需要更多的進一步研究。
목적：연구N말단-전B형납뇨태(NT-proBNP)수평동태변화대중증감호병방(ICU)환자사망적예측개치。방법회고성분석수도의과대학부속북경흉과의원ICU적58례사망환자적림상자료，련속감측저사환자각개시간단NT-proBNP적수치，분석NT-proBNP급기변화치대환자예후적판단개치。용COX회귀방법연구NT-proBNP급NT-proBNP변화치여사망적상관성。결과 NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin여생존시간명현상관(P<0.05)，OR치결과분별위1.205(95%CI：1.201~1.208)、1.303(95%CI：1.298~1.307)、0.896(95%CI：0.893~0.898)。결론NT-proBNP 24、NT-proBNP 48 d、NT-proBNPmin가능시ICU환자사망적예측인소，NT-proBNP 24、NT-proBNP 48 d여병사솔정정상관，NT-proBNPmin여병사솔정부상관。단시NT-proBNP결과필수결합림상배경래응용화해석，여하재경다혼잡인소적배경하연구NT-proBNP대ICU환자예후적영향잉연수요경다적진일보연구。
Objective To investigate the prognostic value of NT-proBNP and the change in NT-proBNP level in the dead cases with different kinds of diseases. Methods Clinical data of 58 non-survivors conducted in the ICU of Beijing Chest Hospital, Capital Medical University were retrospectively analyzed, the level of NT-proBNP and the change of NT-proBNP in different stage were measured and recorded. Diagnostic performances of NT-proBNP and the change of NT-proBNP were analyzed. The correlation between NT-proBNP, change of NT-proBNP and the survival time were tested using COX regression test. Results NT-proBNP 24, NT-proBNP 48, NT-proBNPmin were correlated with survival time and the correlation remained statistically significant using COX regression analysis (P < 0.05) ,the OR value of which were 1.205 (95%CI: 1.201-1.208), 1.303 (95%CI: 1.298-1.307), 0.896 (95%CI: 0.893-0.898) respectively. Conclusion NT-proBNP 24, NT-proBNP 48 d, NT-proBNPmin measured during ICU can act as a predictor for mortality in ICU. The measurements of NT-proBNP 24 and NT-proBNP 48 d are positive correlation with mortality, NT-proB-NPmin are negative correlation with mortality. However, the results should not be used in isolation from the clinical con-text. Further research is required to unravel the significance of elevated BNP levels in different confounding factors.
