降钙素原、氨基末端B型脑钠肽前体、白蛋白检测对重症慢性阻塞性肺疾病患者疾病转归的预测价值  

Predictive value of procalcitonin,N-terminal B-type brain natriuretic peptide precursor and albumin detection for disease prognosis in patients with severe chronic obstructive pulmonary disease

作　　者：刘云云 吴蔚 LIU Yunyun;WU Wei(Department of Respiratory and Critical Care Medicine,Jiujiang University Affliated Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]九江学院附属医院呼吸与危重症医学科,江西九江332000

出　　处：《中国当代医药》2025年第9期18-21,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202131087)。

摘　　要：目的探讨重症慢性阻塞性肺疾病患者血清降钙素原(PCT)、氨基末端B型脑钠肽前体(NT-proBNP)、白蛋白(ALB)在患者疾病转归中的预测价值。方法回顾性分析2021年8月至2023年9月九江学院附属医院收治的60例重症慢性阻塞性肺疾病患者病历资料,按照患者28d疾病转归情况分为死亡组(12例)及存活组(48例),抽取静脉血检测血清PCT、NT-proBNP、ALB水平。分析影响重症慢性阻塞性肺疾病患者病情转归的相关因素(包括性别、年龄、体重指数、慢性阻塞性肺疾病病程、机械通气时间、PCT、NT-proBNP及ALB水平),并分析血清PCT、NT-proBNP、ALB在重症慢性阻塞性肺疾病患者病情转归中的预测价值。结果单因素分析结果显示,两组患者性别、年龄、体重指数、慢性阻塞性肺疾病病程比较,差异无统计学意义(P>0.05);存活组机械通气时间短于死亡组,PCT、NT-proBNP、ALB水平均低于死亡组,差异有统计学意义(P<0.05)。多因素分析结果显示,血清PCT(β=2.972,0R=19.524,95%CI:7.956~47.914,P<0.001)、NT-proBNP(β=0.812,0R=2.251,95%CI:1.456~3.481,P<0.001)、ALB(β=3.135,0R=23.000,95%CI:7.210~73.370,P<0.001)水平上升是重症慢性阻塞性肺疾病患者病情转归的独立危险因素,而机械通气时间(β=-1.081,0R=0.339,95%CI:0.135~0.849,P=0.021)较短则是重症慢性阻塞性肺疾病患者病情转归的独立保护因素。采用联合检测的方式对重症慢性阻塞性肺疾病病情转归的预测价值最高,AUC为0.908,灵敏度为0.917,特异度为0.687;其次为ALB,AUC为0.856,灵敏度为0.833特异度为0.750;PCT的AUC为0.812,灵敏度为0.750,特异度为0.771;NT-proBNP的AUC为0.729,灵敏度为0.667,特异度为0.604。结论血清PCT、NT-proBNP、ALB联合检测在评估重症慢性阻塞性肺疾病患者病情转归中的临床应用价值较高,通过分析各指标水平的变化情况评估患者病情发展,为进一步诊疗提供可靠参考,具有较高的临床推广应用价值。Objective To investigate the predictive value of serum procalcitonin(PCT),N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)and albumin(ALB)in the prognosis of patients with severe chronic obstructive pulmonary disease.Methods The medical records of 60 patients with severe chronic obstructive pulmonary disease admitted to Jiujiang University Affiliated Hospital from August 2021 to September 2023 were retrospectively analyzed,and the patients were di-vided into death group(12 cases)and survival group(48 cases)according to their 28-day disease outcomes.The serum levels of PCT,NT-proBNP and ALB were detected by venous blood samples.The relevant factors affecting the prognosis of patients with severe chronic obstructive pulmonary disease(including gender,age,body mass index,chronic obstructive pulmonary disease course,mechanical ventilation time,PCT,NT-proBNP and ALB levels)were analyzed.The predictive value of serum PCT,NT-proBNP and ALB in the progno-sis of patients with severe chronic obstructive pulmonary disease was analyzed.Results Univariate analysis showed that there were no significant differences in gender,age,body mass index and chronic obstructive pulmonary disease course between two groups(P>0.05).The mechanical ventila-tion time of the survival group was shorter than that of the death group,and the levels of PCT,NT-proBNP and ALB were lower than those of the death group,with statistical significances(P<0.05).The results of multivariate analysis showed that increased levels of serum PCT(β=2.972,OR=19.524,95%CI:7.956-47.914,P<0.001),NT-proBNP(β=0.812,OR=2.251,95%CI:1.456-3.481,P<0.001),ALB(β=3.135,0R=23.000,95%CI:7.210-73.370,P<0.001)were inde-pendent risk factors for death in patients with severe chronic obstructive pulmonary disease,while mechanical ventilation time(β=-1.081,0R=0.339,95%CI:0.135-0.849,P=0.021)was independent protective factor for the prognosis of patients with severe chronic obstructive pulmonary disease.Combined detection had the highest predictive value in the progno

关 键 词：重症慢性阻塞性肺疾病 降钙素原 氨基末端B型脑钠肽前体 白蛋白 预后 

分 类 号：R563.9[医药卫生—呼吸系统]