氨基末端脑钠肽前体对急性主动脉夹层预后判断的临床意义  

Clinical Significance of NT-proBNP Detection in Prognosis of Acute Aortic Dissection

作　　者：李晓明[1] 王舒莹[2] 刘震岳[2] 张建民[2] 

机构地区：[1]河北省承德医学院附属医院检验科,067000 [2]河北省承德医学院附属医院输血科,067000

出　　处：《临床输血与检验》2015年第4期312-316,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨氨基末端脑钠肽前体（NT-proBNP）检测在急性主动脉夹层（acute aortic dissection,AAD）患者的危险性判断及预后评估中的临床意义。方法回顾本院2009年1月1日～2012年1月1日期间AAD患者的病例资料并随访。根据患者预后分为继续分离组和未分离组,通过组间单因素比较及多因素Logistic回归分析等方法,评价各因素与患者不良预后的相关性。结果最终纳入68例患者进行研究,平均年龄（48.68±7.21）岁,继续分离组和未分离组分别为28例（41.2%）和40例（58.8%）。与未分离组相比,继续分离组的年龄、吸烟史、高血压史、糖尿病史、休克指数〉1、血肌酐含量、NT-proBNP含量的差异有统计学意义。将该指标引入多因素Logistic回归分析,得出最佳线性方程由年龄、吸烟史、高血压史、休克指数〉1、NT-proBNP构成,将该5项危险因素行ROC曲线检验并计算曲线下面积,判别其检验效能,纳入NT-proBNP后曲线下面积为0.901,较未纳入时显著增加,且曲线的Youden指数较未纳入时显著升高。结论 NT-proBNP升高将增加急性主动脉夹层患者不良预后的风险,将该检验指标纳入急性主动脉夹层的评测体系,可进一步增强评估该病患者高危风险的能力。Objective To explore the significance of NT-proBNP detection in prognosis and assessment for the risk of acute aortic dissection（AAD）.Methods Clinical data of patients with ovarian cancer in a hospital from January 2009 to January 2012 was reviewed and followed up.The patients were divided into continuous peeling group and no-peeling group according to the prognosis of the disease.The single factor and multivariate logistic regression analyses were used to evaluate the relationship between the risk factors and prognosis of the patients.Results The study covered 68 patients,with an average age of 48.68±7.21 years,including 28（41.2%）cases of continuous peeling group and 40（58.8%）cases of no-peeling group.Compared with the no-peeling group,the continuous peeling group showed a significantly statistical defference in age,smoking,hypertension,diabetes,shock index〉1,and high NT-proBNP.The indicators of the introduction of multifactor logistic regression analysis include age,the history of smoking,and hypertension.The five risk factors were subjected to ROC curve test in logistic regression analysis to calculate the area under the curve.In comparision with the the factors,NT-proBNP gave rise to a notable effect on the area under the curve（0.901）and an increased Youden index.ConclusionElevated NT-proBNP will increase the risk of acute aortic dissection of patients leading to a poor prognosis.NT-proBNP detection may enhance the value of diagnosis for high risk of acute aortic dissection.

关 键 词：急性主动脉夹层 预后 氨基末端脑钠肽前体 

分 类 号：R543.1[医药卫生—心血管疾病] R446.11[医药卫生—内科学]