摘要
目的探讨血清N末端B型脑钠肽前体(NT-pro BNP)、TNF-α、IL-6在急性呼吸窘迫综合征(ARDS)严重程度及预后评估中的应用价值。方法将80例ARDS患者根据2012年ARDS柏林标准以病情严重程度分为轻、中、重度ARDS组,各20、22、38例,采用ELISA法测定并比较各组入院时血清NT-p ro BNP、TNF-α和IL-6水平;根据住院28d的死亡情况,将患者分为死亡组与生存组,各30、50例,比较两组入院时NT-pro BNP、TNF-α和IL-6水平。应用ROC曲线评价NT-pro BNP、TNF-α和IL-6水平对ARDS患者死亡的预测价值。结果中度ARDS组患者血清NT-p ro BNP、TNF-α和IL-6水平高于轻度ARDS组(t=4.55、7.97、2.85,均P<0.01),重度ARDS组患者血清NT-pro BNP、TNF-α和IL-6水平均高于中度ARDS组(t=7.77、7.57、4.00,均P<0.01)。死亡组NT-p ro BNP、TNF-α、IL-6均明显高于存活组(t=8.35、9.68、8.77,均P<0.01)。NT-p ro BNP、IL-6、TNF-αAUC分别为0.852、0.806、0.767,NT-p ro BNP与患者死亡呈正相关(r=0.437,P<0.01)。结论血NT-p ro BNP、TNF-α和IL-6水平可早期预测ARDS病情严重程度及预后。
Objective To assess the roles of serum NT-proBNP,TNF-α and IL-6 levels in evaluation of severity and prognosis in patients with acute respiratory of distress syndrome（ARDS）.Methods Eighty patients with ARDS were divided into mild,moderate and severe groups according to the 2012 ARDS standards for Berlin.Serum NT-proBNP,TNF-α and IL-6 levels were detected with ELISA method.Patients were divided into survival and fatal groups according the mortality within 28 d of hospitalization.Serum NT-proBNP,IL-6 and TNF-α levels were compared between the survival and fatal groups.ROC curve were used to evaluate the value of NT-proBNP,IL-6 and TNF-α levels in predicting mortality of patients with ARDS.Results Serum NT-proBNP,TNF-α and IL-6 levels in moderate ARDS group were higher than those in mild ARDS group（t=4.55,7.97 and 2.85,P 〈0.01）.Serum NT-proBNP,TNF-α and IL-6 levels in severe ARDS group were higher than those in moderate ARDS group（t=1.11,7.57 and 4.00,P〈0.01）.Serum NT-proBNP,TNF-α and IL-6 levels in fatal group were higher than those in the survival group（t= 8.35,9.68 and 8.77,P〈 0.01）.The area under ROC curve（AUC） of NT-proBNP,IL-6 and TNF-α levels were0.852,0.806 and 0.767,respectively.The NT-proBNP levels were positively correlated with the 28-day mortality（P〈0.01）.Conclusion Serum NT-proBNP,IL-6 and TNF-α levels are effective indexes for the assessment of severity and prognosis in patients with ARDS.syndrome
出处
《浙江医学》
CAS
2016年第22期1808-1810,1841,共4页
Zhejiang Medical Journal
基金
义乌市科研计划项目(13-3-30)
义乌市医学重点学科建设资助项目(13-ZD03)
