老年危重症患者BNP水平与APACHE Ⅱ评分的相关性及与预后的关系.pdf

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1、实用老年医学2014年9月第28卷第9期PractGeriatr，Sep2014．Vo1．28，No．9745老年危重症患者BNP水平与APACHE1I评分的相关性及与预后的关系顾永辉程惠邓晓静徐剑卞叶萍【摘要】目的探讨老年危重症患者的脑钠肽(BNP)水平与急性生理学与慢性健康状况Ⅱ评分(APACHElI)的相关性及与预后的关系。方法选取128例老年危重症患者，检测30min内静脉血浆BNP，计算24h内的APACHEH分值。根据APACHEH分值将患者分为高危组(>20分)、中危组(10~20分)和低危组(<10分)，比较3组间BNP水平

2、的差异。结果BNP水平在高危组(567．02pg／m1)明显高于中危组(385．79pg／m1)和低危组(30．30pg／m1)(P<0．01)，且和APACHEⅡ评分呈显著正相关(r=0．489，P：0．028)；根据28d生存情况将患者分为存活组与死亡组，存活组患者BNP水平(2l1．93pg／m1)及APACHEH评分(21．05±7．80)均明显低于死亡组的BNP水平(697．40pg／m1)及APACHEⅡ评分(28．19+l1．17)(P<0．05)；多因素Logistic回归分析提示BNP水平为28d死亡的危险因素(P=0．0

3、34)。结论老年危重症患者BNP水平与APACHElI评分及病死率呈正相关，可作为评价病情危重程度及预后的指标。【关键词】脑钠肽；急性生理学与慢性健康状况Ⅱ评分；预后；老年人[中图分类号]R459．7[文献标识码]Adoi：10．3969／j．issn．1003—9198．2014．09．012CorrelationbetweenserumB·typenatriureticpeptideandacutephysiologyandchronichealthevaluationHscoreandprognosisofelderlyseverep

4、atientsGU，‘9一hui，CHENGHui，DENGXiao-jing，XUJian，BIANYe-ping．TheIn—tensiveCareUnitofJiangsuProvinceGeriatricHospital，Nanjing210024，China【Abstract】0bjectiveToexploretherelationshipbetweenB—typenatriureticpeptide(BNP)andacutephysiologyandchronichealthevaluationⅡscore(APACHEHsc

5、ore)inelderlyseverepatients，andtoinvestigatetherelationshipofBNPwithprognosis．Methods128elderlypatientsinICUwereenrolledinthisstudy．TheplasmalevelofBNPwasde—tectedin30min，andAPACHEUscorewascalculatedin24h．Thepatientsweredividedintohishriskgroup(>20)，mediumriskgroup(10—20)a

6、ndlowriskgroup(<10)accordingtoAPACHEⅡscore．ResultsTheBNPlevelinthehighriskgroup(567．02pg／m1)wassignificantlyhigherthanthatoftheothertwogroups(P<0．01)；andtheBNPlevelwaspositivelycorrelatedwithAPACHEIIscore(r：0．489，P=0．028)．Allthepatientsweredividedintothesurvivalgroupandthe

7、deadgroupaccordingtothe28thday’ssurvivalsituation．ThelevelofBNP(211．93Pr／m1)andAPACHEIIscore(21．05±7．80)inthesurvivalgroupweresignificantlylowerthanthoseinthedeadgroup(P<0．05)．MultivariateLogisticregressionanalysisshowedthatBNPlevelwasariskfactorformortality(P=0．034)．Concl

8、usionsThelevelofBNPispositivelycorrelatedwithAPACHEⅡscoreandmortalityrate．whichcanbeusedt