氨基末端脑利钠肽前体水平对非HIV免疫损害患者肺炎的预后价值  

Role of N-terminal pro-brain natriuretic peptide level in predicting prognosis of pneumonia in non-HIV immunocompromised patients

作　　者：骆海伦 李昱霖[1] 梁志欣[1] 陈良安[1] 

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《解放军医学院学报》2014年第2期116-118,共3页Academic Journal of Chinese PLA Medical School

基　　金：全军医学科技"十二五"科研项目(BWS11J057)~~

摘　　要：目的评价氨基末端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平对非HIV免疫损害患者肺炎预后的预测作用。方法回顾性研究本院呼吸重症监护病房(respiratory intensive care unit,RICU)2011年1月-2013年5月收治的非HIV免疫损害患者肺炎的临床资料。收集入RICU 24 h内的NT-proBNP测定值。根据ICU生存情况,分为死亡组和存活组,比较两组间NT-proBNP、APACHEⅡ评分的差异。结果本研究入选患者44例,死亡18例,存活26例。死亡组的NT-proBNP水平(中位数3 066.5 pg/ml)显著高于存活组(中位数372.0 pg/ml)。NT-proBNP和APACHEⅡ评分预测ICU病死率的受试者工作曲线下面积分别为0.707(95%置信区间[0.552,0.862])和0.841(95%置信区间[0.712,0.961])。结论氨基末端脑利钠肽前体水平升高提示预后差,其对非HIV免疫损害患者肺炎的预后价值仍需进一步研究。Objective To study the role of N-terminal pro-brain natriuretic peptide （NT-proBNP） level in predicting the prognosis of pneumonia in non-HIV immunocompromised patients. Methods Clinical data about pneumonia in non-HIV immunocompromised patients admitted to respiratory intensive care unit（RICU） in our hospital from January 2011 to May 2013 were retrospectively analyzed. The NT-proBNP level in non-HIV immunocompromised patients was measured within 24 h after admission. The patients were divided into death group and survival group according to their mortality in RICU. The NT-proBNP and APACHE Ⅱ scores were compared between the 2 groups. Results Of the 44 patients included in this study, 18 died and 26 survived. The NT-proBNP level was significantly higher in death group than in survival group （3 066.5 pg/ml vs 372.0 pg/ml）. The area under the ROC curves for the mortality in RICU as predicted with the NT-proBNP and APACHE Ⅱ scores was 0.707 （95% CI： 0.552, 0.862） and 0.841（95% CI： 0.712, 0.961） , respectively. Conclusion Elevated NT-proBNP level indicate a poor prognosis of pneumonia in non- HIV immunocompromised patients. Its value in predicting the prognosis of pneumonia in non-HIV immunocompromised patients needs to be further studied.

关 键 词：免疫损害宿主肺炎 氨基末端脑利钠肽前体 预后 

分 类 号：R563.1[医药卫生—呼吸系统]