血清氨基末端脑钠肽前体/胆碱酯酶比值评估危重患者预后的临床价值  

Value of the serum amino terminal brain natriuretic peptide/CHE ratio in the prognosis of critical patients

作　　者：宋熔[1] 牛芳[1] 晁列艳[1] 任航旗[1] 王红丽[1] 

机构地区：[1]中国人民解放军第五医院重症医学科,银川750004

出　　处：《检验医学与临床》2017年第9期1248-1250,共3页Laboratory Medicine and Clinic

基　　金：银川市科技局项目(YCKJ-2013-57)

摘　　要：目的探讨血清氨基末端脑钠肽前体(NT-proBNP)与血清胆碱酯酶(CHE)浓度比值对评估危重患者病情及预后的价值。方法对150例ICU危重患者在入院24h内进行急性生理学及慢性健康状况评估Ⅱ(APACHEⅡ)评分,测定NT-proBNP及CHE浓度,计算NT-proBNP/CHE,并采集年龄、性别、既往病史、ICU入住时间、是否为脓毒症、预后等基本资料。根据预后分为死亡组和存活组,分析APACHEⅡ评分、NT-proBNP/CHE与病情及预后关系。结果死亡组APACHEⅡ评分、NTproBNP,NT-proBNP/CHE高于存活组,差异有统计学意义(P<0.05);NT-proBNP,NT-proBNP/CHE与APACHEⅡ评分具有相关性(r=0.186,P<0.05;r=0.181,P<0.05);单因素Logistic分析发现危重患者病死率与患者高血压病史、ICU入住时间、APACHEHⅡ评分、NT-proBNP水平、NT-proBNP/CHE相关(P<0.05)。多因素Logistic回归显示,APACHEⅡ评分、NTproBNP/CHE是影响为危患者病死率的独立危险因素(P<0.05),ROC曲线下面积(AUC)分别是0.709、0.801。结论危重患者NT-proBNP/CHE比值可以作为病情评估和预后判断方面的指标,具有一定的临床价值。Objective To investigate the clinical prognostic value of value of the serum amino terminal brain natriuretic peptide （NT-proBNP）/cholinesterase （CHE） ratio in the prognosis of critical patients.Methods The acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） score was done during 24 hours of admission in 150 critical patients.NT-proBNP and CHE concentration,NT-proBNP/CHE ratio were measured and calculated.Those of age,gender,medical history,ICU stay time,whether the patients were sepsis and prognosis were collected for all patients.APACHEⅡ score,NT-proBNP/CHE and the relationships of them with the severity of illness state or prognosis were analyzed between death group and survival group.Results APACHEⅡ score,NT-proBNP and NT-proBNP/CHE in death group were significantly higher than that of the survival group （P〈0.05）.NT-proBNP and NT-proBNP/CHE were correlated with APACHEⅡ score （r=0.186,P〈0.05;r=0.181,P〈0.05）.Logistic regression analysis showed that the mortality was related to a history of hypertension,ICU stay time,APACHEHⅡ score,NT-proBNP levels and NT-proBNP/CHE （P〈0.05）.Multivariate Logistic regression analysis showed that APACHEⅡ score and NT-proBNP/CHE were the independent risk factors for mortality（P〈0.05）,with areas under the curve （AUC） of ROC were 0.709 and 0.801.Conclusion NT-proBNP/CHE ratio could be used as an independent predictor for evaluating severity of illness state and prognosis in critical patients,which has certain dinical value.

关 键 词：氨基末端脑钠肽前体 胆碱酯酶 APACHEⅡ评分 预后 

分 类 号：R363.27[医药卫生—病理学]