血清NT-proBNP与PCT在医院获得性肺炎病情及预后评估中的应用

Value of serum NT-proBNP and PCT in the diagnosiscondition and prognosis of hospital acquired pneumonia

目的探讨N-末端脑钠肽前体(N-terminal brain natriuretic peptide precursor,NT-pro-BNP)与降钙素原(PCT)在医院获得性肺炎病情及预后评估中的价值。方法选取2015年1月-2018年2月于医院治疗的医院获得性肺炎患者82例设为肺炎组,选取同期健康志愿者80例作为对照组,检测两组研究对象的血清NT-proBNP、PCT。结果肺炎组血清NT-proBNP、PCT分别为2301.46(1089.29,3744.29)pg/L和(1.31±0.22)ng/ml高于对照组(P<0.001);肺炎组高危险患者血清NT-proBNP和PCT分别为3032.18(2674.39,4010.02)pg/L和(1.51±0.31)ng/ml高于低危险和中危险患者(P<0.05);肺炎组中危险患者血清NT-proBNP和PCT分别为2200.67(1100.80,3011.43)pg/L和(1.22±0.19)ng/ml高于低危险患者(P<0.05);死亡患者血清NT-proBNP、PCT分别为2890.56(1719.40,3744.29)pg/L和(1.62±0.28)ng/L高于存活患者(P<0.05);血清NT-proBNP、PCT判断肺炎患者预后的ROC曲线下面积分别为0.963和0.889,差异有统计学意义(P<0.05),NT-proBNP、PCT截断值分别为2526.33 pg/L和1.55 ng/ml,灵敏度分别为90.10%和75.00%,特异度分别为92.00%和91.00%。结论血清NT-proBNP、PCT在医院获得性肺炎患者病情及预后评价中有一定应用价值,可为临床诊治提供参考。

OBJECTIVE To evaluate the value of N-terminal brain natriuretic peptide precursor(NT-pro-BNP)and procalcitonin(PCT)in hospital acquired pneumonia condition and prognosis.METHODS From Jan.2015 to Feb.2018,82 patients with acquired pneumonia(pneumonia gourp)were treated in our hospital,and 80 healthy volunteers were selected as the control group,and the levels of serum NT-proBNP and PCT were detected in two groups.RESULTS The serum NT-proBNP and PCT in the pneumonia group were 2301.46(1089.29,3744.29)pg/L and(1.31±0.22)ng/ml,which were significantly higher than that in the control group(P<0.001).The serum NT-proBNP and PCT of patients with high risk of pneumonia group were 3032.18(2674.39,4010.02)pg/L and(1.51±0.31)ng/ml,which were significantly higher than those of low risk and middle risk patients(P<0.05);The serum NT-proBNP and PCTin the patients with middle risk of pneumonia group were 2200.67(1100.80,3011,43)pg/L and(1.22±0.19)ng/ml,which were significantly higher than those of low risk patients(P<0.05);The serum NT-proBNP and PCT of the dead patients were 2890.56(1719.40,3744.29)pg/L and(1.62±0.28)ng/ml,which were significantly higher than those of the surviving patients(P<0.05).The area of serum NT-proBNP and PCT to determine the prognosis of pneumonia patients was 0.963 and 0.889(P<0.05),NT-proBNP and PCT cut-off values were 2526.33 g/L and 1.55 ng/ml,and the sensitivity were 90.10%and 75.00%respectively,and the specificity were 92.00%and 91.00%.CONCLUSION Serum NT-proBNP and PCT have certain application value in evaluating the condition and prognosis of patients with hospital acquired pneumonia,which can provide reference for clinical diagnosis and treatment.