急性呼吸窘迫综合征患者血浆氨基末端B型脑利钠肽前体水平的临床意义

Clinical Significance of Plasma Amino-terminal Pro-B-type Natriuretic Peptide Precursor Levels in Patients with Acute Respiratory Distress Syndrome

目的探讨急性呼吸窘迫综合征(ARDS)患者血浆氨基末端B型脑利钠肽前体(NT-proBNP)水平的临床意义。方法选取2011年1月—2015年6月四川省人民医院急诊收治的ARDS患者134例作为研究组,另选取同期于四川省人民医院体检健康者60例作为对照组。收集受试者的临床资料,并进行相关性分析及多因素Logistic回归分析。结果研究组患者血清NT-proBNP水平高于对照组(P<0.05)。血浆NT-proBNP水平不同四分位区间患者Mmray急性肺损伤评分、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、病情严重程度和病死率比较,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血浆NT-proBNP水平与Murray急性肺损伤评分、APACHEⅡ评分、病情严重程度和病死率呈正相关(r值分别为0.632、0.526、0.713、0.482,P<0.05)。多因素Logistic回归分析结果显示,血浆NT-proBNP水平q2(OR=2.14,95%CI(1.52,3.01)q3[OR=3.23,95%CI(2.18,4.79)]、q4[OR=5.94,95%CI(3.26,10.82)]是ARDS患者死亡的影响因素(P<0.05)。结论 ARDS患者血浆NT-proBNP水平较高,其可作为判定患者病情严重程度及预后的重要指标。

Objective To explore the clinical significance of plasma amino - terminal pro - B - type natriuretic peptide precursor （ NT - proBNP） levels in patients with acute respiratory distress syndrome （ ARDS）. Methods A total of 134 patients with ARDS were selected in the Peopled Hospital, Sichuan from January 2011 to June 2015 selected as the study group, a total of 60 healthy people were selected as the control group. The elinical data collected subjects, correlation analysis and multiple logistic regression analysis. Results Level of plasma NT - proBNP of study group was significantly higher than control group （P 〈0. 05）. Murray acute lung injury score, APACHE Ⅱ scores, severty of illness and case fatality rate showed significant differences in differences interquartile range of plasma NT - proBNP level （ P 〈 0. 05 ） . Pearson correlation analysis showed that plasma NT - proBNP levels positively correlated to Murray acute lung injury score, APACHE Ⅱ scores, severty of illness and case fatality rate （r = 0. 632, 0. 526 , 0. 713 , 0. 482, P 〈 0. 05 ）. Multiple logistic regression analysis showed that plasma NT - proBNP level q2 （OR=2.14, 95% Cl （1.52, 3.01）]. q3 [OR=3.23, 9 5 % Cl （2.18, 4.79）]. q4 [OR =5. 94, 95% CI （3. 26, 10. 82） ] was influence factors of ARDS patients died. Conclusion The plasma NT - proBNP level is relatively high in ARDS patients, which can judge patients as an important index of severity and prognosis.