N末端-前B型钠尿肽水平动态变化对重症监护室患者死亡的预测价值  

Dynamic changes of NT-pro BNP level value for predicting the death of patients with ICU

作　　者：张宝秋[1] 宋其生 史剑权[3] 吴恩东[3] 

机构地区：[1]首都医科大学附属北京胸科医院检验科,北京101149 [2]辽宁省大连市结核病医院结核科,辽宁大连116033 [3]首都医科大学附属北京胸科医院ICU,北京101149

出　　处：《中国医药导报》2015年第2期94-97,102,共5页China Medical Herald

摘　　要：目的研究N末端-前B型钠尿肽（NT-pro BNP）水平动态变化对重症监护病房（ICU）患者死亡的预测价值。方法回顾性分析首都医科大学附属北京胸科医院ICU的58例死亡患者的临床资料,连续监测这些患者各个时间段NT-pro BNP的数值,分析NT-pro BNP及其变化值对患者预后的判断价值。用COX回归方法研究NT-pro BNP及NT-pro BNP变化值与死亡的相关性。结果 NT-pro BNP 24、NT-pro BNP 48 d、NT-pro BNPmin与生存时间明显相关（P〈0.05）,OR值结果分别为1.205（95%CI：1.201~1.208）、1.303（95%CI：1.298~1.307）、0.896（95%CI：0.893~0.898）。结论 NT-pro BNP 24、NT-pro BNP 48 d、NT-pro BNPmin可能是ICU患者死亡的预测因素,NT-pro BNP24、NT-pro BNP 48 d与病死率呈正相关,NT-pro BNPmin与病死率呈负相关。但是NT-pro BNP结果必须结合临床环境来应用和解释,如何在更多混杂因素的环境下研究NT-pro BNP对ICU患者预后的影响仍然需要更多的进一步研究。Objective To investigate the prognostic value of NT-proBNP and the change in NT-proBNP level in the dead cases with different kinds of diseases. Methods Clinical data of 58 non-survivors conducted in the ICU of Beijing Chest Hospital, Capital Medical University were retrospectively analyzed, the level of NT-proBNP and the change of NT-proBNP in different stage were measured and recorded. Diagnostic performances of NT-proBNP and the change of NT-proBNP were analyzed. The correlation between NT-proBNP, change of NT-proBNP and the survival time were tested using COX regression test. Results NT-proBNP 24, NT-proBNP 48, NT-proBNPmin were correlated with survival time and the correlation remained statistically significant using COX regression analysis （P 〈 0.05） ,the OR value of which were 1.205 （95%CI： 1.201-1.208）, 1.303 （95%CI： 1.298-1.307）, 0.896 （95%CI： 0.893-0.898） respectively. Conclusion NT-proBNP 24, NT-proBNP 48 d, NT-proBNPmin measured during ICU can act as a predictor for mortality in ICU. The measurements of NT-proBNP 24 and NT-proBNP 48 d are positive correlation with mortality, NT-proB-NPmin are negative correlation with mortality. However, the results should not be used in isolation from the clinical con-text. Further research is required to unravel the significance of elevated BNP levels in different confounding factors.

关 键 词：B型钠尿肽 N末端-前B型钠尿肽 重症监护病房 病死率 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]