降钙素原联合 N-末端前体脑钠肽检测对重症呼吸衰竭患者预后评估的价值

摘要

Objective To investigate the value of the detection of procalcitonin (PCT ) combined with N‐terminal pro brain natriuretic peptide (NT‐proBNP) on prognosis of patients with severe respiratory fail‐ure.Methods Ninety‐six cases of patients with type Ⅱ respiratory failure were chosen and divided into survival group(n=59) and death group(n=37) .The PCT ,NT‐proBNP and APACHE Ⅱ score index were analyzed to study the relationship between PCT ,NT‐proBNP and the prognosis of the patients.Results The PCT ,NT‐proB‐NP and APACHE‐Ⅱ scores in the survival group were lower than those in death group ,there was significant difference between two groups ( P < 0.05) .Pearson correlation analysis showed that ,PCT (r= 0.432 , P=0.021) ,NT‐proBNP (r=0.324 ,P=0.031) ,and APACHE Ⅱ scores were statistically correlated .ROC curve a‐nalysis showed that PCT ,NT‐proBNP and APACHE‐Ⅱ scores had higher sensitivity and specificity for predicting mortality .In survival group ,PCT and NT‐proBNP of 4 cases were greater than the critical value .While among the death group ,PCT and NT‐proBNP of 34 cases were greater than the critical value .The sensitivity and speci‐ficity of PCT combined with NT‐proBNP detection were 79.1% ,91.9% in death prediction of the patients .Con‐clusion PCT ,NT‐proBNP and other indicators have higher value in evaluation of the prognosis in patients with severe respiratory failure ,and the combination can improve the detection sensitivity and specificity ,which is wor‐thy of further clinical research.%目的：探讨降钙素原（PCT）联合N‐末端前体脑钠肽（NT‐proBNP）检测对重症呼吸衰竭患者预后评估的价值。方法选取Ⅱ型重症呼吸衰竭患者96例的临床资料，其中，存活组59例，死亡组37例。对2组PCT、NT‐proBNP及急性生理学与慢性健康状况评分系统（APACHE Ⅱ）评分等指标进行评价，分析 PCT、NT‐proBNP与患者预后的关系。结果存活组患者PCT、NT‐proBNP与APACHE Ⅱ评分均低于死亡组，差异有统计学意义（P＜0.05）。Pearson相关性分析表明，受试者工作特征曲线（PCT）（r＝0.432，P＝0.021）、NT‐proBNP （r＝0.324，P＝0.031），均与APACHE Ⅱ评分有统计学相关性。ROC曲线分析表明，PCT、NT‐proBNP与 A‐PACHE Ⅱ评分对患者死亡预测的敏感性和特异性均较高。存活组59例中，PCT及NT‐proBNP均大于临界值者4例，死亡组37例中，PCT及NT‐proBNP均大于临界值者34例。PCT联合NT‐proBNP检测对患者死亡预测的敏感性和特异性分别为79.1％、91.9％。结论 PCT、NT‐proBNP等指标对于重症呼吸衰竭患者预后评估的价值较高，两者联合可提高检测敏感性和特异性，值得临床深入研究。