NT-BNP检测对重症肺炎患者临床诊治及预后评估的意义

Significance of NT-BNP detection in clinical diagnosis,treatment,and prognosis of patients with severe pneumonia

目的探讨N末端脑钠肽(NT-BNP)水平检测在重症肺炎患者临床诊治及预后评估中的意义。方法选择2019年1月至2020年6月韶关市铁路医院ICU接诊的76例重症肺炎患者纳入研究(重症肺炎组),根据治疗10 d后预后情况分为死亡组26例和存活组50例,选择同期于本院接受体检的50例健康者作为对照组。比较重症肺炎组确诊后即刻(治疗前)及对照组体检者当日的血清NT-BNP水平,比较重症肺炎死亡组和存活组患者治疗前、治疗3 d、5 d时的血清NT-BNP水平和急性生理与慢性健康评分(APACHEⅡ)的变化,采用Pearson相关性分析血清NT-BNP水平和APACHEⅡ评分的相关性。结果重症肺炎组患者的血清NT-BNP水平为(895.95±240.11)pg/mL,明显高于对照组的(371.86±46.03)pg/mL,差异有统计学意义(P<0.05);治疗前、治疗后3 d、5 d时,死亡组患者的血清NT-BNP水平分别为(1260.31±231.91)pg/mL、(1445.95±336.17)pg/mL、(1700.21±317.03)pg/mL,明显高于存活组的(613.93±151.82)pg/mL、(503.71±126.84)pg/mL、(438.05±93.21)pg/mL,死亡组患者的APACHEⅡ评分分别为(25.15±2.70)分、(29.03±3.16)分、(34.26±2.74)分,明显高于存活组的(20.20±2.36)分、(18.13±2.01)分、(15.75±2.41)分,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清NT-BNP水平与APACHEⅡ评分之间呈正相关(r=0.509,P<0.05)。结论重症肺炎患者血清NT-BNP水平表达明显升高,对其检测有助于评估患者预后情况。

Objective To study the significance of N-terminal brain natriuretic peptide(NT-BNP)detection in clinical diagnosis,treatment,and prognosis of patients with severe pneumonia.Methods Seventy-six patients with se-vere pneumonia admitted to ICU of Shaoguan Railway Hospital from January 2019 to June 2020 were selected(severe pneumonia group),which were divided into death group(26 cases)and survival group(50 cases)according to the prog-nosis after 10 days of treatment.Fifty healthy people who received physical examination in the hospital during the same period were selected as the control group.The serum NT-BNP levels between the severe pneumonia group immediately after diagnosis(before treatment)and the control group on the day of physical examination were compared,the changes of serum NT-BNP levels,acute physiology and chronic health score(APACHEⅡ)between the death group and the sur-vival group at before treatment,3 d after treatment and 5 d after treatment were compared.Pearson correlation analysis was used to analyze the correlation between serum NT-BNP level and APACHEⅡscore.Results The serum NT-BNP level in severe pneumonia group was(895.95±240.11)pg/mL,which was significantly higher than(371.86±46.03)pg/mL in the control group(P<0.05).Before treatment,3 d and 5 d after treatment,the serum NT-BNP levels in the death group were(1260.31±231.91)pg/mL,(1445.95±336.17)pg/mL,(1700.21±317.03)pg/mL,which were significantly higher than(613.93±151.82)pg/mL,(503.71±126.84)pg/mL,(438.05±93.21)pg/mL in the survival group,and the APACHEⅡscores in the death group were(25.15±2.70)points,(29.03±3.16)points,(34.26±2.74)points,which were significantly higher than(20.20±2.36)points,(18.13±2.01)points,(15.75±2.41)points in survival group,with statistically significant difference(P<0.05).Pearson correlation analysis showed that there was a positive correlation between serum NT-BNP levels and APACHEⅡscores(r=0.509,P<0.05).Conclusion The serum NT-BNP levels is significantly increased in pa-tients with severe pneumonia infection,and the detection of NT-BNP can help to evaluate the prognosis of patients.