血浆NT-proBNP和APACHE Ⅱ评分在难治性心衰患者预后中的价值研究

Evaluation of the Plasma NT-proBNP and APACHE Ⅱ Score in the Prognosis for Patients with Refractory Congestive Heart Failure

目的探讨血浆N末端脑钠肽原(NT-proBNP)水平及急性生理与慢性健康评分(APACHEⅡ评分)与难治性心力衰竭患者预后的相关性及其在预后评价中的应用价值。方法选择2016年3月—2017年9月在医院ICU接受治疗的50例难治性心衰患者作为研究对象,所有患者入科30mim内抽取静脉血检测NT-ProBNP值,在患者入科后24h内临床表现最严重时进行APACHEⅡ评分。根据28d生存情况将所有患者分为存活组(38例)和死亡组(12例)。比较两组患者NT-ProBNP间及水平APACHEⅡ评分,计算NT-ProBNP与APACHEⅡ评分之间的相关性。结果死亡组患者的血浆NT-proBNP水平及APACHEⅡ评分均明显高于存活组患者(P<0.05);入科时NT-proBNP水平及APACHEⅡ评分显著相关(P<0.05),且二者与难治性心力衰竭患者预后显著相关(P<0.05)。结论难治性心力衰竭患者进入ICU时的血浆NT-proBNP水平及APACHEⅡ评分密切相关,且二者与患者预后之间存在相关性,可作为患者短期生存状态的预测因子。

Objective To investigate the correlation between plasma Plasma N-terminal ProBrain Natriureticpeptide,（ NT-proBNP） levels,Acute Physiology and Chronic Health Evaluation（ APACHE Ⅱ） score and the prognosis for patients with refractory congestive heart failure and the value of such correlation in prognosis evaluation. Methods We observed 50 patients with refractory heart failure who were admitted to ICU in our hospital from March 2016 to September 2017.Their venous blood samples were collected within 30 minutes after admission to detect the NT-ProBNP value. APACHE Ⅱscore was given upon their most severe clinical manifestations within 24 hours after admission. The patients were divided into a survival group（ n = 38） and a death group（ n = 12） according to their 28-day survival status. The NT-ProBNP level and APACHE Ⅱ score were compared between the two groups,and the correlation between NT-ProBNP and APACHE Ⅱ scores was analyzed. Results The plasma NT-proBNP level and APACHE Ⅱ score of patients in the death group were significantly higher than those of the survival group patients（ P 0. 05）. The NT-proBNP level and APACHE Ⅱ score were significantly correlated（ P 0. 05）; and the prognosis for patients with refractory heart failure was significantly correlated with their NT-proBNP level and APACHE Ⅱ score（ P 0. 05）. Conclusion The plasma NT-proBNP level of patients with refractory heart failure when they are admitted to ICU and their APACHE Ⅱ scores are closely related. There is a correlation between plasma NT-proBNP level,APACHE Ⅱ scores and the prognosis for patients with refractory heart failure,which can be considered as the predictor of short-term survival status of patients.