成人重症新冠肺炎NT-proBNP升高患者的临床特征及其对院内死亡的影响

Clinical characteristics of COVID-19 patients with increased NT-proBNP and its impact on in-hospital death

目的:探讨入院首次血清N末端B型脑钠肽前体(NT-proBNP)升高的成人重症新型冠状病毒肺炎(COVID-19)患者的临床特征,并分析NT-proBNP是否为院内死亡的影响因素。方法:回顾性分析2020年1月22日至3月6日在武汉亚心总医院连续收治的105例成人重症COVID-19确诊病例。将患者分为NT-proBNP升高组(n=54)和NT-proBNP正常组(n=51),分析两组的临床特征,采用多因素logistic回归分析NT-proBNP与患者院内死亡的关系。结果:与正常组相比,NT-proBNP升高组指脉氧饱和度、淋巴细胞计数、白蛋白水平更低(P<0.05或P<0.01);更多使用抗病毒、激素及无创与有创呼吸机支持(P<0.05或P<0.01);急性呼吸窘迫综合征、休克、院内死亡的发生率更高(P<0.01)。NTpro BNP升高为院内死亡的危险因素(P<0.05)。结论:入院首次NT-proBNP水平升高在成人重症COVID-19患者中比例较高,为成人重症COVID-19患者院内死亡的危险因素。

Objective:To investigate the clinical characteristics of adult patients with severe COVID-19 and increased serum NT-proBNP at hospital admission,and to analyze whether NT-proBNP is the influencing factor for in-hospital death.Methods:A total of 105 adult patients with severe COVID-19 admitted to Wuhan Asia General Hospital from January 22 to March 6,2020 were retrospectively analyzed.The patients were divided into increased NT-proBNP group(n=54)and normal NT-proBNP group(n=51).The clinical characteristics of the two groups were analyzed,and the relationship between NT-proBNP and in-hospital death was analyzed by multivariate logistic regression.Results:Compared with the normal group,the increased NT-proBNP group had low finger pulse oxygen saturation,lymphocyte count and albumin level(P<0.05 or P<0.01),more use of antiviral,hormone and noninvasive and invasive ventilator support(P<0.05 or P<0.01),and high incidence of acute respiratory distress syndrome,shock and in-hospital death(P<0.01).Increased NT-pro BNP was a risk factor for in-hospital death(P<0.05).Conclusion:The increase of NT-proBNP level at hospital admission has a high proportion in adult patients with severe COVID-19,which is a risk factor for in-hospital death of these patients.