| 郭庆玲,冯家华,梁秋亭.PCT、BNP联合APACHEⅡ评分对呼吸重症监护患者预后的评估价值.[J].中南医学科学杂志.,2021,(4):431-434. |
| PCT、BNP联合APACHEⅡ评分对呼吸重症监护患者预后的评估价值 |
| Value of PCT and BNP combined with APACHEⅡ score in prognosis evaluation of patients in respiratory intensive care unit |
| 投稿时间：2021-02-08 修订日期：2021-03-08 |
| DOI：10.15972/j.cnki.43-1509/r.2021.04.014 |
| 中文关键词: 呼吸重症监护 降钙素原 脑钠肽 急性生理与慢性健康Ⅱ评分 |
| 英文关键词:respiratory intensive care unit procalcitonin brain natriuretic peptide acute physiology and chronic health evaluationⅡ score |
| 基金项目:广东省科技计划项目(2016A040405065)；东莞市社会科技发展项目(2018507150251292) 作者简介:郭庆玲,副主任医师,研究方向为呼吸常见病、肺癌及重症疑难疾病诊疗,E-mail为qmeliv@163.com。 |
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| 中文摘要: |
| 目的观察降钙素原(PCT)、脑钠肽(BNP)联合急性生理与慢性健康Ⅱ(APACHEⅡ)评分对呼吸重症监护患者预后的评估价值。方法选取呼吸重症监护病房(RICU)290例呼吸重症患者进行回顾性分析,根据28天内生存情况,将其分为存活组与死亡组,比较两组入院第1天、3天、5天APACHEⅡ评分、PCT和BNP表达水平,分析患者预后影响因素及PCT、BNP联合APACHEⅡ评分对预后的预测价值。结果28天内290例患者死亡72例(24.83%),存活218例(75.17%)。存活组入院第1天、3天、5天APACHEⅡ评分、PCT和BNP表达水平均明显低于死亡组(P＜0.05)。存活组与死亡组C反应蛋白(CRP)、PCT、BNP、APACHEⅡ评分差异有统计学意义(P＜0.05)。Logistic回归分析显示,PCT、BNP、APACHEⅡ评分为RICU呼吸重症患者死亡独立危险因素(P＜0.05)。受试者工作特征(ROC)曲线分析显示,PCT预后评估灵敏度为79.5%,特异度为77.3%；BNP灵敏度为70.2%,特异度为78.2%；APACHEⅡ评分灵敏度为84.2%,特异度为71.5%；三者联合预测灵敏度为92.6%,特异度为90.1%。结论PCT、BNP联合APACHEⅡ评分能更好地评估呼吸重症监护患者的预后。 |
| 英文摘要: |
| To observe the prognostic value of procalcitonin (PCT), brain natriuretic peptide (BNP) combined with acute physiology and chronic health Ⅱ (APACHE Ⅱ) score in patients with respiratory intensive care. Methods290 patients in respiratory intensive care unit (RICU) were divided into survival group and death group. APACHE Ⅱ score, PCT and BNP expression levels were compared between the two groups on the first day, the third day and the fifth day after admission. The prognostic factors and the predictive value of PCT, BNP combined with APACHE Ⅱ score were analyzed. Results72 cases (24.83%) died and 218 cases (75.17%) survived within 28 days. The APACHE Ⅱ score, PCT and BNP expression levels of the survival group on the first, third and fifth day after admission were significantly lower than those of the death group (P＜0.05). The C-reactive protein (CRP), PCT, BNP and pacheii scores in survival group were significantly higher than those in death group (P＜0.05). Logistic regression analysis showed that PCT, BNP and pacheii scores were the independent risk factors for death of respiratory critical patients in RICU (P＜0.05). Receiver operating characteristic (ROC) curve analysis showed that the sensitivity and specificity of PCT were 79.5% and 77.3%, respectively; The sensitivity and specificity of BNP were 70.2% and 78.2%, respectively; The sensitivity and specificity of APACHE Ⅱ score were 84.2% and 71.5%, respectively; The sensitivity and specificity were 92.6% and 90.1% respectively. ConclusionPCT, BNP combined with APACHE Ⅱ score can be used as the prognosis evaluation index of respiratory intensive care patients, and better predict the prognosis. |
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