血浆NT-proBNP水平与老年髋部骨折患者院内死亡风险的相关性研究  

Relationship between plasma NT-proBNP level and risk of in-hospital mortality in elderly patients with hip fracture

作　　者：周朝波[1] 王欣彤[1] 梁立格 杨丽晖[1] 席少华[1] ZHOU Chao-bo;WANG Xin-tong;LIANG Li-ge(Department of Orthopedics, 2 Department of Laboratory, The Second Affiliated Hospital of Xingtai Medical College, Xingtai Hebei 054000, China.)

机构地区：[1]邢台医学高等专科学校第二附属医院骨科,河北邢台054000 [2]邢台医学高等专科学校第二附属医院检验科,河北邢台054000

出　　处：《临床和实验医学杂志》2018年第20期2195-2198,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省邢台市科技计划项目(编号:2016ZC068)

摘　　要：目的探讨血浆N末端B型利钠肽原(NT-proBNP)与老年髋部骨折患者院内死亡风险的相关性。方法回顾性选取2010年3月至2017年10月收治的老年髋部骨折患者110例,在患者入院当天检测血浆NT-proBNP水平,并记录院内预后情况。根据预后分成死亡组与生存组,比较两组临床特征。通过绘制受试者工作特征曲线(ROC)分析血浆NT-proBNP对老年髋部骨折死亡的预测价值,明确最佳截断值,采用Logistic回归分析明确院内死亡的独立危险因素。结果在110例老年髋部骨折患者中,死亡23例(20.91%),生存87例(79.09%),23例死亡患者伤后平均生存时间为(10.18±3.16)d。生存组保守治疗、合并心肌损害、受伤7 d后治疗占比低于死亡组,且生存组血浆NTproBNP水平低于死亡组,差异有统计学意义(P<0.05)。血浆NT-proBNP预测患者院内死亡的曲线下面积为0.885,以大于最佳截断值347.503 pg/L时死亡风险更高。经Logistic回归分析发现合并心肌损害、治疗时机(受伤7 d后治疗)、治疗方式(保守治疗)以及血浆NT-proBNP(>347.503 pg/L)是老年髋部骨折患者院内死亡的独立危险因素(P<0.05)。结论血浆NT-proBNP对老年髋部骨折患者院内死亡风险具有一定预测价值,且它是患者院内死亡的独立危险因素。血浆NT-proBNP水平越高,死亡风险越大,二者呈正相关。Objective To investigate the relationship between plasma N terminal B type natriuretic peptide and risk of in-hospital mortality in elderly patients with hip fracture. Methods 110 elderly patients with hip fractures treated in our hospital from March 2010 to October 2017 were selected and the plasma NT-proBNP level was measured on the day of admission and the prognosis was recorded. The patients were divided into the death group and the survival group according to their prognosis. The clinical characteristics of the two groups were compared. The receiver operating characteristic curve （ROC） was used to analyze the predictive value of plasma NT-proBNP in elderly patients with hip fracture and to determine the optimal cut-off value. Logistic regression analysis was used to identify the independent risk factors affecting the prognosis of patients . Results Among the 110 elderly patients with hip fractures, there were 23 cases death （20.91%）, 87 cases survival （79.09%）, and the average survival time （10.18±3.16） days after injury in 23 cases of death. Survival group, conservative treatment, combined myocardial injury, injury after 7 d treatment accounted for less than the death group, and survival group plasma NT-proBNP level was lower than the death group. The difference was statistically significant （ P 〈0.05）. The area under the curve of plasma NT-proBNP in predicting hospital mortality was 0.885, and the risk of death was higher when 347.503 pg/L was higher than the optimal cut-off value. Logistic regression analysis showed that combined myocardial damage, treatment time （after 7 d treatment）, treatment （conservative treatment） and plasma NT-proBNP （〉347.503 pg/L） were independent risk factors in hospital death of elderly hip fractures （ P 〈0.05）. Conclusion Plasma NT-proBNP has a certain predictive value for the risk of in-hospital mortality in elderly patients with hip fracture. And it is an independent risk factor for patients＇ hospital death. With the higher pla

关 键 词：老年人 髋部骨折 N 末端 B 型利钠肽原 院内死亡 

分 类 号：R683[医药卫生—骨科学]