早期NT-proBNP、NLR及PLR对急性一氧化碳中毒心肌损伤的预测价值  

Forecast value of NT-proBNP,NLR and PLR on myocardial injury after acute carbon monoxide poisoning

作　　者：郑爱华[1] 才立云[1] 王克宇[1] ZHENG Ai-hua;CAI Li-yun;WANG Ke-yu(Emergency Internal Medicine,Tangshan Gongren Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山工人医院急诊内科

出　　处：《现代预防医学》2019年第15期2824-2828,共5页Modern Preventive Medicine

基　　金：河北省2018年度医学科学研究重点课题计划项目(No.20181268)

摘　　要：目的探讨早期N-末端前脑钠肽(NT-proBNP)、中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞比值(PLR)对急性一氧化碳中毒(ACOP)心肌损伤的预测价值。方法选择2015年1月-2018年1月该院收治的82例ACOP患者为研究对象,以入院3 h血清心肌肌钙蛋白I(cTnI)升高作为诊断心肌损伤的标准,应用二元logistic回归分析患者ACOP后心肌损伤的危险因素,采用ROC曲线评价入院时NT-proBNP、NLR及PLR值对ACOP后心肌损伤的预测价值。结果 ACOP后心肌损伤者32例(39.02%),无心肌损伤者50例(60.98%),心肌损伤组男性比例、吸烟者比例、NT-proBNP水平及NLR、PLR值均高于无心肌损伤组,差异有统计学意义(P<0.05或P<0.01)。血清NT-proBNP水平及NLR、PLR值升高是ACOP后心肌损伤的危险因素(P<0.05)。NLR值预测ACOP后心肌损伤的AUC、敏感度及准确性最高(分别为0.916、0.875、0.866),血清NT-proBNP的特异度最高(0.940)。结论 ACOP早期血清NT-proBNP水平及NLR、PLR值是ACOP后心肌损伤的危险因素,NLR、PLR值更适合于ACOP后心肌损伤的早期预测及筛查。Objective To investigate the forecast value of NT-proBNP,NLR and PLR on myocardial injury after acute carbon monoxide poisoning.Methods 82 ACOP patients of our hospital from January 2015 to January 2018 were selected as the research object,the level of serum cardiac Troponin I(cTnI)at 3 h in hospital was used as the diagnostic criteria for myocardial injury,the risk factors of myocardial injury after ACOP were analyzed by binary logistic regression,and ROC curve was used to evaluate the forecast value of NT-proBNP,NLR and PLR on myocardial injury after ACOP.Results After ACOP,there were 32 cases of myocardial injury(39.02%)and 50 cases of no myocardial injury(60.98%).The proportion of male patients,the proportion of smokers,NT-proBNP,NLR and PLR were significantly higher in the myocardial injury group thannon-myocardial injury group and the differences had statistical significance(P<0.05 or P<0.01).Serum NT-proBNP,NLR and PLR were independent risk factors for myocardial injury after ACOP(P<0.05).NLR value had the highest sensitivity and accuracy in predicting AUC of myocardial injury after ACOP(0.916,0.875 and 0.866,respectively)and serum nt-proBNP had the highest specificity(0.940).Conclusion NT-proBNP,NLR and PLR in early ACOP are independent risk factors for myocardial injury after ACOP.NLR and PLR values are more suitable for early forecast and screening of myocardial injury after ACOP.

关 键 词：心肌肌钙蛋白I N-末端前脑钠肽 一氧化碳中毒 心肌损伤 

分 类 号：R113[医药卫生—公共卫生与预防医学]