血浆氨基末端脑钠肽前体水平与新生儿疾病严重程度及预后的相关性  

Correlation between plasma NT-proBNP level and neonatal disease severity and prognosis

作　　者：曾群[1] 彭华保[1] 欧阳燕峰 贺晓旭[1] 肖志兵[1] Zeng Qun;Peng Huabao;Ouyang Yanfeng(Department of Neonatology, Chenzhou No.1 People’s Hospital affiliated to University of South China,Chenzhou,Hunan 423000,China)

机构地区：[1]南华大学附属郴州市第一人民医院新生儿重症监护科,湖南郴州423000

出　　处：《湘南学院学报（医学版）》2020年第4期17-21,共5页Journal of Xiangnan University（Medical Sciences）

基　　金：郴州市科技局一般科技计划项目(czkj2016047)。

摘　　要：目的探讨血浆氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平与新生儿危重病例评分法(NCIS)分值的相关性,阐明血浆NT-proBNP水平对判断新生儿危重程度及预后的临床价值。方法选取郴州市第一人民医院新生儿重症监护室收治的体质量>2500 g、37周≤胎龄<42周、出生后24 h内入院的危重新生儿为研究对象,根据NCIS分值分为极危重组(n=43)、危重组(n=65);非危重组(n=71)为同期入住普通新生儿科的足月新生儿;极危重组根据转归分为存活组(n=33)和死亡组(n=10)。所有患儿均于入院第1天采用NCIS进行评分并行血浆NT-proBNP检测。比较各组血浆NT-proBNP水平,分析血浆NT-proBNP水平与NCIS分值的相关性。结果入院第1天,极危重组血浆NT-proBNP水平高于危重组(P<0.05),危重组血浆NT-proBNP水平高于非危重组(P<0.05);血浆NT-proBNP水平与NCIS分值呈负相关(r=-0.900,P<0.001);死亡组血浆NT-proBNP水平高于存活组(P<0.05);入院第1天血浆NT-proBNP水平预测极危重新生儿的ROC曲线下面积(AUC)为0.967,最佳临界值为26824 pg/mL时,灵敏度为88%,特异性为97%。结论血浆NT-proBNP与病情危重程度密切相关,病情越重,NT-proBNP水平越高,NT-proBNP对判断病情轻重及预后有一定临床意义。Objective To investigate the correlation between plasma NT-proBNP level and NCIS score,and to clarify the clinical application value of plasma NT-proBNP level in the evaluation of severity and prognosis of newborns.Methods The critically ill newborns with gestational age of 37~41+6 weeks and birth weight of more than 2500 g who were admitted to the neonatal intensive care unit(NICU),Chenzhou No.1 People’s Hospital affiliated to the University of South China within 24 hours after birth were selected as the study.According to NCIS scores,the patients were divided into extremely critical group(n=43)and critical group(n=65);the control group(non-critical group,n=71)was the full-term who were admitted to the general neonatal department in the same period;according to the prognosis,extremely critical group were divided into survival group(n=33)and death group(n=10).All the newborns were evaluated with NCIS and tested with NT-proBNP on the first day of admission.Plasma NT-proBNP levels were compared in each group,and the correlation between plasma NT-proBNP levels and NCIS scores was analyzed.Results On the first day after admission,the level of plasma NT-proBNP in the extremely critical group was higher than that in the critical group,the level of plasma NT-proBNP in the critical group was higher than the non-critical group(P<0.05).The level of plasma NT-proBNP was negatively correlated with NCIS(r=-0.900,P<0.001).Compared with survival group,the level of plasma NT-proBNP was higher in death group(P<0.05).The area under receiver operator characteristic(ROC)curve of extremely critical ill newborns predicted by the plasma NT-proBNP level on the first day after admission was 0.967,the optimal critical point was 26824 pg/mL,the sensitivity was 88%,and the specificity was 97%.Conclusion The level of plasma NT-proBNP is closely related to disease severity,the more severe the disease,the higher the level of plasma NT-proBNP,measurement of NT-proBNP level has certain clinical significance for the judgment of severity and pro

关 键 词：新生儿 氨基末端 脑钠肽前体 重症监护室 

分 类 号：R722.1[医药卫生—儿科]