cTnT、NT-proBNP、Lac及APACHEⅡ评分与AECOPD伴呼吸衰竭患者预后的相关性分析  

APACHEⅡ scores and plasma CTnT, NT-proBNP, lactate levels in prognosis of AECOPD patients with respiratory failure

作　　者：李雪翔[1] 程景林[1] 戚金威[1] 

机构地区：[1]安徽医科大学第二附属医院急诊内科,合肥230601

出　　处：《浙江医学》2017年第14期1192-1194,1213,共4页Zhejiang Medical Journal

摘　　要：目的探讨血浆肌钙蛋白T(cTnT)、N末端脑钠肽前体(NT-proBNP)、乳酸(Lac)水平及APACHEⅡ评分与慢性阻塞性肺疾病急性加重期(AECOPD)伴呼吸衰竭患者预后的关系。方法回顾102例AECOPD伴呼吸衰竭患者临床资料,根据预后分为好转组73例和死亡组29例,比较两组cTnT、NT-proBNP、Lac水平及APACHEⅡ评分的差异,分析cTnT、NT-proBNP、Lac水平及APACHEⅡ评分与AECOPD伴呼吸衰竭患者预后的关系。结果死亡组的cTnT、NT-proBNP、Lac水平及APACHEⅡ评分均高于好转组,差异均有统计学意义(均P<0.05);多因素logistic回归分析显示cTnT、NT-proBNP、Lac水平和APACHE II评分是死亡的危险因素(均P<0.05);Pearson相关分析提示,NT-proBNP与cTnT呈正相关(P<0.01)。结论 cTnT、NT-proBNP。Objective To assess the prognostic value of plasma cardiac troponint （cTnT）,N-terminal pro-brain natriuretic peptide （NT-proBNP）,lactate （Lac） levels and Apache Ⅱ （Acute Physiology and Chronic Health Evaluation Ⅱ） scores for patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with respiratory failure.Methods The clinical data of 102 AECOPD patients complicated with respiratory failure admitted in our hospital were retrospectively reviewed.The plasma levels of cTnT,NT-proBNP,Lac and APACHE Ⅱ scores of survival patients （n=73） and fatal ones （n=29） were compared,and the correlations of above variables with clinical outcomes were analyzed.Results The plasma CTnT,NT-proBNP,Lac levels and APACHE Ⅱ scores in fatal group were all higher than those in survival group（all P〈0.05）.Multivariate Logistic regression analysis showed that cTnT,NT-proBNP,Lac levels and APACHEⅡ scores were significantly correlated with poor prognosis of patients （all P〈0.05）.Pearson correlation analysis showed that NT-proBNP was positively correlated with cTnT （P 〈0.01）.Conclusion Plasma levels of cTnT,NT-proBNP,Lac and APACHE Ⅱ scores are correlated with the clinical outcomes in AECOPD patients with respiratory failure,suggesting that these variables may be used for prognostic indicators.

关 键 词：肌钙蛋白-T N末端脑钠肽前体 乳酸 急性生理与慢性健康状况评分Ⅱ 慢性阻塞性肺疾病急性加重期 

分 类 号：R563.8[医药卫生—呼吸系统] R563.9[医药卫生—内科学]