重症肺炎患者APACHEⅡ评分及脑钠肽水平与预后的关系  

Relationship of APACHEⅡ score and B-type natriuretic peptide levels with clinical outcomes in severe pneumonia patients

作　　者：张泓[1] 王楠[1] 周登川[1] 刘镜泉[1] 戴成才[1] 王良慧[1] 

机构地区：[1]安徽医科大学第一附属医院急诊医学科,合肥230022

出　　处：《临床急诊杂志》2011年第4期235-237,共3页Journal of Clinical Emergency

基　　金：安徽省临床医学技术应用项目(No:2008B062)

摘　　要：目的:分析重症肺炎患者APACHEⅡ评分及脑钠肽等床旁快速检验、评估指标与重症肺炎预后的相关性。方法:对199例2009年11月-2011年3月期间入住急诊重症监护病房的重症肺炎患者进行前瞻性研究,根据有无行机械通气支持治疗将患者分为一般治疗组和机械通气组,采用生命体征监测、APACHEⅡ评分以及床边快速检测脑钠肽、血乳酸等生化检查方法,观察指标变化与患者行机械通气治疗率和30d死亡率的关系。结果:机械通气组患者共63例(32%),机械通气组呼吸、心率等体征异常变化较一般治疗组显著,且APACHEⅡ评分、脑钠肽、血乳酸以及肌酐水平明显增高。APACHEⅡ评分>8,BNP>667ng/L、Cr>142μmol/L、Lac>2mmol/L与需机械通气治疗以及死亡率显著相关。结论:重症肺炎APACHEⅡ评分、脑钠肽水平等是评估患者需行机械通气治疗以及预测死亡率的易操作且安全可靠的指标。Objective：To assess the relationship of determine the APACHE Ⅱ score and B-type natriuretic peptide factors with prognosis in patients with severe pneumonia. Method：199 cases with severe pneumonia admitted from Nov 2009 to Mar 2011 were prospectively analyzed,which divided into general treatment and mechanical ventilation group. The vital sign,APACHE Ⅱ score,B-type natriuretic peptide and other biochemical findings were evaluated. And then the relationship between these parameters and clinical outcome was analyzed. Result：63 patients（32%） accepted mechanical ventilation treatment. Compared to the general treatment group,mechnical ventination group demonstrated significant change of respiratory and heart rate.Moreover,APACHE Ⅱ score,B-type natriuretic peptide,blood lactate and Serum creatinine of mechanical ventilation group were significantly increased. APACHE Ⅱ score 8,BNP667 ng/L,Cr 142 μmol/L and Lac 2 mmol/L related to need for mechanical ventilation and 30d mortality in ICU. Conclusion：APACHE Ⅱ score,BNP,Cr and Lac have prognostic value and were reliable markers for predicting both high risk for mechanical ventilation and mortality.

关 键 词：重症肺炎 APACHEⅡ 脑钠肽 预后 

分 类 号：R563.1[医药卫生—呼吸系统]