NT-proBNP联合APECHEⅡ评分对脑出血术后机械通气撤机的预测价值  

作　　者：李增攀[1] 刘雪兰[1] 蒋坚[1] 董若飞 

机构地区：[1]宁波市医疗中心李惠利医院,315000

出　　处：《浙江临床医学》2025年第3期419-420,423,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医学会临床科研基金项目(2021ZYC-A110)。

摘　　要：目的探讨氨基末端脑钠肽前体(NT-proBNP)、急性生理与慢性健康(APECHEⅡ)评分对脑出血术后患者机械通气撤机结局的预测价值。方法回顾性分析2020年1月至2021年12月EICU收治的156例脑出血术后患者的临床资料,比较撤机成功组与失败组患者的性别、年龄、合并疾病、出血量、机械通气撤机前NT-proBNP、APECHEⅡ评分、机械通气时间、重症监护病房住院时间、总住院时间。采用受试者工作曲线(ROC)及曲线下面积(AUC)分析NT-proBNP联合APECHEⅡ评分对脑出血患者术后撤机结局预测价值。结果撤机成功组与失败组NT-proBNP水平和APECHEⅡ评分差异有统计学意义(P<0.05)。ROC曲线分析结果显示,NT-proBNP和APECHEⅡ评分预测脑出血术后患者机械通气撤机的AUC分别为0.717(95%CI:0.624~0.809,P<0.05)和0.709(95%CI:0.556~0.743,P<0.05),两者联合预测机械通气时间延长的AUC为0.817(95%CI:0.708~0.866,P<0.001),特异度和敏感度分别为0.83和0.73。结论NT-proBNP联合APECHEⅡ评分可以提高急性脑出血患者术后撤机的成功率,具有较好的预测价值。Objective To investigate the value of N-terminal pro b-type natriuretic peptide(NT-proBNP)combined with Acute Physiology And Chronic Health Evaluation Ⅱ(APECHEⅡ)score in predicting the outcome of mechanical ventilation after operation of cerebral hemorrhage.Methods A retrospective study was conducted to analyze the clinical data of postoperative patients with cerebral hemorrhage admitted to EICU of our hospital from January 2020 to December 2021.Gender,age,co-morbidity,blood loss,NT-proBNP before mechanical ventilation withdrawal,APECHEⅡ score,duration of mechanical ventilation,length of stay in intensive care unit,and total length of stay were analyzed and compared between the successful and failed group.Receiver operating curve(ROC)and area under curve(AUC)were used to analyze the predictive value of NT-proBNP combined with APECHEⅡ score for postoperative offline in patients with intracerebral hemorrhage.Results A total of 156 patients with operation of cerebral hemorrhage were included in this study.There were statistical differences in the level of NT-proBNP and the score of APECHEⅡ between the successful and failed groups(P<0.05).ROC curve analysis results showed that the AUC of NT-proBNP and APECHEⅡ scores in predicting the prolonged mechanical ventilation time of postoperative patients with cerebral hemorrhage was 0.717(95%CI:0.624~0.809,P<0.05)and 0.709(95%CI:0.556~0.743,P<0.05),respect ively.Combined prediction AUC of mechanical ventilation duration was 0.817(95%CI:0.708~0.866,P<0.001),and specificity and sensitivity were 0.83 and 0.73,respectively.Conclusion NT-proBNP combined with APECHEII score can improve the success rate of postoperative extubation in patients with operation of cerebral hemorrhage,and has good predictive value.

关 键 词：前氨基末端脑钠肽前体 急性生理与慢性健康评分 脑出血 机械通气 

分 类 号：R743.34[医药卫生—神经病学与精神病学]