中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
11期
11-15
,共5页
急性呼吸窘迫综合征%氨基末端B型脑钠肽%严重程度%预后
急性呼吸窘迫綜閤徵%氨基末耑B型腦鈉肽%嚴重程度%預後
급성호흡군박종합정%안기말단B형뇌납태%엄중정도%예후
Acute respiratory distress syndrome%Amino-terminal pro-B-type natriuretic peptide%Severity%Prognosis
目的：探讨急性呼吸窘迫综合征(ARDS)患者氨基末端B型脑钠肽(NT-proBNP)与病情严重程度及预后的关系。方法选择87例ARDS患者，在积极治疗的同时，根据柏林标准病情严重程度分层分为轻度组、中度组和重度组，根据住院期间预后分为存活组和死亡组，分析不同严重程度及预后相关因素、NT-proBNP与不同病情严重程度和住院期间预后的关系。结果不同严重程度患者APACHEⅡ、Murray、NT-proBNP、肌酐、尿素氮、空腹血糖、pH值差异均有统计学意义(P<0.05)。 APACHEⅡ、Murray、NT-proBNP与ARDS严重程度呈正相关(r=0.595、0.545、0.563，P<0.05)。APACHEⅡ、Murray分别与NT-proBNP呈正相关(r=0.584、0.544，P<0.05)。存活组与死亡组年龄、APACHEⅡ、Murray、NT-proBNP、肌酐、尿素氮、空腹血糖、pH值、氧合指数、肺外器官衰竭数目差异均有统计学意义(P<0.05)。APACHEⅡ、Murray、NT-proBNP、肺外器官衰竭数目是ARDS近期预后独立危险因素，氧合指数是保护因素(P<0.05)。NT-proBNP对ARDS预后判断的ROC曲线下面积为0.798，截点为333.92 pg/mL，灵敏度为81.92%，特异度为91.89%，<登指数为0.732。结论血浆NT-proBNP有助于早期判断ARDS严重程度及住院期间预后，可作为临床预测标志物。
目的：探討急性呼吸窘迫綜閤徵(ARDS)患者氨基末耑B型腦鈉肽(NT-proBNP)與病情嚴重程度及預後的關繫。方法選擇87例ARDS患者，在積極治療的同時，根據柏林標準病情嚴重程度分層分為輕度組、中度組和重度組，根據住院期間預後分為存活組和死亡組，分析不同嚴重程度及預後相關因素、NT-proBNP與不同病情嚴重程度和住院期間預後的關繫。結果不同嚴重程度患者APACHEⅡ、Murray、NT-proBNP、肌酐、尿素氮、空腹血糖、pH值差異均有統計學意義(P<0.05)。 APACHEⅡ、Murray、NT-proBNP與ARDS嚴重程度呈正相關(r=0.595、0.545、0.563，P<0.05)。APACHEⅡ、Murray分彆與NT-proBNP呈正相關(r=0.584、0.544，P<0.05)。存活組與死亡組年齡、APACHEⅡ、Murray、NT-proBNP、肌酐、尿素氮、空腹血糖、pH值、氧閤指數、肺外器官衰竭數目差異均有統計學意義(P<0.05)。APACHEⅡ、Murray、NT-proBNP、肺外器官衰竭數目是ARDS近期預後獨立危險因素，氧閤指數是保護因素(P<0.05)。NT-proBNP對ARDS預後判斷的ROC麯線下麵積為0.798，截點為333.92 pg/mL，靈敏度為81.92%，特異度為91.89%，<登指數為0.732。結論血漿NT-proBNP有助于早期判斷ARDS嚴重程度及住院期間預後，可作為臨床預測標誌物。
목적：탐토급성호흡군박종합정(ARDS)환자안기말단B형뇌납태(NT-proBNP)여병정엄중정도급예후적관계。방법선택87례ARDS환자，재적겁치료적동시，근거백림표준병정엄중정도분층분위경도조、중도조화중도조，근거주원기간예후분위존활조화사망조，분석불동엄중정도급예후상관인소、NT-proBNP여불동병정엄중정도화주원기간예후적관계。결과불동엄중정도환자APACHEⅡ、Murray、NT-proBNP、기항、뇨소담、공복혈당、pH치차이균유통계학의의(P<0.05)。 APACHEⅡ、Murray、NT-proBNP여ARDS엄중정도정정상관(r=0.595、0.545、0.563，P<0.05)。APACHEⅡ、Murray분별여NT-proBNP정정상관(r=0.584、0.544，P<0.05)。존활조여사망조년령、APACHEⅡ、Murray、NT-proBNP、기항、뇨소담、공복혈당、pH치、양합지수、폐외기관쇠갈수목차이균유통계학의의(P<0.05)。APACHEⅡ、Murray、NT-proBNP、폐외기관쇠갈수목시ARDS근기예후독립위험인소，양합지수시보호인소(P<0.05)。NT-proBNP대ARDS예후판단적ROC곡선하면적위0.798，절점위333.92 pg/mL，령민도위81.92%，특이도위91.89%，<등지수위0.732。결론혈장NT-proBNP유조우조기판단ARDS엄중정도급주원기간예후，가작위림상예측표지물。
Objective To investigate the acute respiratory distress syndrome (ARDS) in patients with amino-terminal pro-B-type relationship of brain natriuretic peptide (NT-proBNP) and the severity and prognosis. Methods A total of 87 cases of ARDS patients in active treatment at the same time, according to the severity of Berlin standards groups stratified into mild, moderate and severe groups, divided according to the prognosis of survival group and death group during hospitalization, relationship of different severity and prognostic factors, NT-proBNP with different severity and prognosis during hospitalization were analyzed. Results The severity of the patient APACHEII, Murray, NT-proBNP, creatinine, blood urea nitrogen, fasting glucose, pH value of the differences were statistically significant (P<0.05). APACHEII, Murray, NT-proBNP and severity of ARDS were positively correlated (r=0.595, 0.545, 0.563, P<0.05). APACHEII, Murray was positively correlated with NT-proBNP(r=0.584, 0.544, P<0.05). The differences of age, APACHEII, Murray, NT-proBNP, creatinine, blood urea nitrogen, fasting blood glucose, pH value, oxygenation index, number of extrapul-monary organ failure of survival and nonsurvivors groups were statistically significant (P<0.05). APACHEII, Murray, NT-proBNP, the number of extrapulmonary organ failure were independent risk factor for prognosis ARDS, oxygenation index was a protective factor (P<0.05). The area under the ROC curve for NT-proBNP for prognosis ARDS was 0.798, cut-off point for 333.92 pg/mL, the sensitivity of 81.92% and the specifici ty was 91.89%, Youden index was 0.732. Conclusion Plasma NT-proBNP helps early prognosis of ARDS severity and duration of hospitalization, can be used as markers of clinical predictors.
