监测血浆脑钠肽对机械通气患者脱机失败的预测作用  

Role of measurement of serum brain natriuretic peptide in prediction of mechanical ventilation weaning failure

作　　者：周平[1] 董芸[1] 常莉[1] 王建东[1] 李依[1] 李俊英[1] 冯璇璘[1] 邓磊[1] 郑君[1] 

机构地区：[1]四川省医学科学院.四川省人民医院急诊ICU,四川成都610072

出　　处：《实用医院临床杂志》2013年第5期69-71,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨血浆脑钠肽(BNP)预测机械通气患者脱机失败的作用。方法选择44例脱机困难患者,监测BNP基础值、自主呼吸试验(SBT)前后的BNP值,比较脱机成功组和脱机失败组的BNP基础、BNP前、BNP后及急性生理学慢性健康学(APACHEⅡ)评分、年龄。绘制BNP前的ROC曲线。结果本组患者28天内脱机成功28例,失败16例,脱机成功率为63.64%。脱机失败组BNP基础、BNP前、BNP后均明显高于脱机成功组,差异有统计学意义(P<0.05)。BNP前的ROC曲线下面积为0.871,当BNP前≥204 pg/ml时,其预测脱机失败的灵敏度为87.5%,特异度为82.1%。结论监测BNP能识别可能出现脱机失败的患者,脱机前BNP≥204 pg/ml时预示患者会出现脱机失败。Objective To investigate the predictive value of B-type natriuretic peptide in mechanical ventilation patients with weaning failure. Methods Serum BNP was measured for basic values, before and after of spontaneous breathing test （SBT） in 44 pa- tients with difficult offline. The patients were divided into weaning success group and weaning failure group. Serum concentrations of BNPbasic, BNPbefore, and BNPafter, APACHE Ⅱ score and age were compared between the two groups. Then, receiver operating characteris- tic curve（ROC） analysis of BNPbefore was performed. Results Of these patients ,28 cases were weaning success and 16 cases were wea- ning failure within 28 days. The success rate of weaning was 63.64%. The BNPbasic, BNPbefore and BNPafter in the weaning failure group were significantly higher than that in the success group（P 〈 0. 05 ）. The AUC of BNPbefore Was 0. 871. When serum BNPbefore≥ 204 pg/ ml, sensitivity of predicting weaning failure was 87.5 % and specificity was 82. 1%. Conclusion Measurement of serum BNP can iden- tify patients with weaning failure. The BNP levels 〉 204 pg/ml indicates that patients may have a possibility of weaning failure.

关 键 词：B型脑钠肽 机械通气 脱机失败 预测 

分 类 号：R563.9[医药卫生—呼吸系统]