CAJ | 학술논문

目的：探讨自主呼吸试验前后NT-proBNP差值对非心源性危重症机械通气患者撤机结局的预测价值。方法选取2013年1月~2014年10月在本院内科ICU病房接受机械通气治疗的60例非心源性危重症患者作为研究对象,按照撤机结局分为成功组(n=49)和失败组(n=11)。采用受试者工作特征(ROC)曲线评价自主呼吸试验前后NT-proBNP差值预测撤机成功率的价值。结果成功组自主呼吸试验后的NT-proBNP水平显著低于失败组,差异有统计学意义(P<0.01)。成功组自主呼吸试验前后的NT-proBNP差值显著低于失败组,差异有统计学意义(P<0.01)。自主呼吸试验前后NT-proBNP差值预测撤机失败的ROC曲线下面积为0.935±0.035,以NT-proBNP上升581.5 pg/ml为拐点,预测撤机成功的灵敏度为90.9%,特异度为87.8%。结论自主试验前后NT-proBNP的变化可作为撤机结局的一种预测指标,联合自主呼吸试验能提高撤机的成功率。
목적：탐토자주호흡시험전후NT-proBNP차치대비심원성위중증궤계통기환자철궤결국적예측개치。방법선취2013년1월~2014년10월재본원내과ICU병방접수궤계통기치료적60례비심원성위중증환자작위연구대상,안조철궤결국분위성공조(n=49)화실패조(n=11)。채용수시자공작특정(ROC)곡선평개자주호흡시험전후NT-proBNP차치예측철궤성공솔적개치。결과성공조자주호흡시험후적NT-proBNP수평현저저우실패조,차이유통계학의의(P<0.01)。성공조자주호흡시험전후적NT-proBNP차치현저저우실패조,차이유통계학의의(P<0.01)。자주호흡시험전후NT-proBNP차치예측철궤실패적ROC곡선하면적위0.935±0.035,이NT-proBNP상승581.5 pg/ml위괴점,예측철궤성공적령민도위90.9%,특이도위87.8%。결론자주시험전후NT-proBNP적변화가작위철궤결국적일충예측지표,연합자주호흡시험능제고철궤적성공솔。
Objective To explore the predicting value of the difference between the NT-proBNP before and after the spontaneous breathing trial on weaning outcome of the non-cardiogenic critical illness patients with mechanical venti-lation. Methods 60 non-cardiogenic critical illness patients with mechanical ventilation in the department of internal medicine in our hospital from January 2013 to December 2014 were selected and divided into the success group (n=49) and the failure group (n=11)according to the outcome of weaning.The value of NT-proBNP difference in predicting the suc-cess rate of weaning was evaluated by using receiver operating characteristic (ROC) curve. Results The level of NT-proB-NP after the spontaneous breathing trial in the success group was lower than that in the failure group,with significant difference(P<0.01).The difference value between the NT-proBNP before and after the spontaneous breathing trial in the success group was lower than that in the failure group,with significant difference(P<0.01).The area under cure (AUC) of the ROC cure of NT-proBNP difference before and after the spontaneous breathing trial to predict the failure of wean-ing was 0. 935±0.035,the cut-off level of NT-proBNP was 581.5 pg/ml and the sensitivity was 90.9%,specificity was 84.7%.Conclusion The change of NT-proBNP before and after the spontaneous breathing trial can be used as one of the screening indicators for weaning,combined with spontaneous breathing trial can raise the successful rate ofweaning.