HBP、NT-proBNP联合SOFA评分预测脓毒症休克预后价值分析  

Prognostic value of HBP and NT-proBNP combined with SOFA score in predicting the prognosis of septic shock

作　　者：衡军锋[1] 吴丁烨[1] HENG Junfeng;WU Dingye(Department of Emergency Medicine,Wuxi People's Hospital,Wuxi Jiangsu 214000,China)

机构地区：[1]无锡市人民医院重症医学科,江苏无锡214000

出　　处：《中国急救复苏与灾害医学杂志》2021年第9期1020-1023,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省卫健委面上项目(编号:H201645)。

摘　　要：目的分析肝素结合蛋白(heparin binding protein,HBP)、N-末端B型利钠肽原(n-terminal pro-b-type natriuretic peptide,NT-proBNP)、序贯器官衰竭评分(sequential organ failure assessment,SOFA)对脓毒症休克预后的预测价值。方法选取2018年10月-2020年10月在无锡市人民医院治疗的脓毒症休克患者80例,均进行血清HBP、NT-proBNP检测及SOFA评估。根据患者治疗后28 d的转归情况分为预后不良组与预后良好组。使用单因素及多因素Logistic回归分析评价HBP、NT-proBNP、SOFA评分是否为影响脓毒症休克患者预后的相关因素。ROC曲线评价HBP、NT-proBNP联合SOFA评分对脓毒症休克患者预后的预测效能。结果80例脓毒症休克患者死亡率为40.00%;预后不良组急性生理和慢性健康评分(acute physiology and chronic health evaluation II,APACHE II)评分、SOFA评分、血乳酸(lactic acid,Lac)、降钙素原(procalcitonin,PCT)、C反应蛋白(c-reactive protein,CRP)、HBP、NT-proBNP均高于预后良好组(P<0.05),多因素Logistic回归分析显示以上均是影响脓毒症休克患者预后的独立危险因素(P<0.05)。工作特征曲线(receiver operating characteristic curve,ROC)曲线评价HBP、NT-proBNP联合SOFA评分预测脓毒症休克预后的曲线下面积(AUC)为0.843,均高于HBP、NT-proBNP、SOFA评分单独预测的0.796、0.635、0.797。结论HBP、NT proBNP、SOFA评分均是影响脓毒症休克患者预后的独立危险因素,三者联合对预后预测有较高的效能,可用于临床治疗的指导。Objective To analyze the predictive value of heparin-binding protein(HBP)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)combined with sequential organ failure assessment(SOFA)scores on the prognosis of septic shock.Methods A total of 80 patients with septic shock who were treated in Wuxi People's Hospital from Octo‐ber 2018 to October 2020 were selected.Serum HBP,NT-proBNP detection and SOFA evaluation were performed.Ac‐cording to the outcome of 28 days after treatment,patients were divided into poor prognosis group and good prognosis group.Univariate and multivariate Logistic regression analysis were used to evaluate whether HBP,NT-proBNP and SOFA scores are related factors affecting the prognosis of patients with septic shock.ROC curve was used to evaluate the prognostic efficacy of HBP,NT proBNP combined with SOFA score in patients with septic shock.Results The mor‐tality rate of 80 patients with septic shock was 40.00%.The APACHE II score,SOFA score,lactic acid(Lac),procalci‐tonin(PCT),c-reactive protein(CRP),HBP,and NT-proBNP in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Multivariate logistic regression analysis showed that the above were independent risk factors affecting the prognosis of patients with septic shock(P<0.05).The area under the curve(AUC)of ROC curve for predicting the prognosis of septic shock by HBP,NT-proBNP and SOFA score was 0.843,which was higher than 0.796,0.635 and 0.797 predicted by HBP,NT-proBNP and SOFA score alone.Conclusion HBP,NT-proBNP,and SOFA score are all independent risk factors that affect the prognosis of patients with septic shock.The combination of the three has high efficacy in predicting the prognosis,and can be used for clinical treatment guidance.

关 键 词：脓毒症休克 肝素结合蛋白 N-末端B型利钠肽原 序贯器官衰竭评分 

分 类 号：R459.7[医药卫生—急诊医学]