摘要
目的探讨B型脑钠肽作为社区获得性肺炎预后指标的价值。方法本研究为多中心、回顾性研究。收集2014年1月1日至2015年12月31日在北京、青岛和昆明四家三级医院住院的社区获得性肺炎(CAP)患者的临床资料,包括人口学特征、临床症状体征、实验室检查和影像学资料。单因素分析法和logistic回归分析法探讨与CAP 30 d病死率相关的危险因素。受试者工作曲线(ROC)评价血浆B型脑钠肽(BNP)>1000 pg/ml、英国胸科协会改良肺炎评分(CURB-65评分)以及血浆BNP>1000 pg/ml+CURB-65评分(B-CURB65)对CAP 30 d死亡风险的预测能力。结果共有1786例CAP患者纳入最后分析,30 d病死率4.7%(84/1786)。Logistic回归分析证实血浆BNP>1000 pg/ml是CAP患者30 d死亡的独立危险因素(OR=2.624,P=0.001,95%CI:1.496~4.601)。B-CURB65预测CAP 30 d死亡其曲线下面积(AUC)为0.774,高于CURB-65评分(AUC=0.625,P=0.002)。结论BNP是一个有价值的与CAP预后相关的生物学标志物;联合CURB-65评分能显著增加对CAP 30 d死亡风险的预测能力。
Objective To explore the value of B-type natriuretic peptide(BNP)be used as a prognostic factor for community-acquired pneumonia.Methods This was a multicenter,retrospective study.Data of patients hospitalized with community-acquired pneumonia during 2014/1/1 to 2015/12/31 from four tertiary hospitals were reviewed,including demographic and clinical features,and outcomes.Univariate analysis and logistic regression analysis were performed to determine risk factors for 30-day mortality.Receiver operating characteristic curves(ROCs)was performed to verify the accuracy of BNP>1000 pg/ml,CURB-65 score and BNP>1000 pg/ml+CURB-65 score(B-CURB65)as 30-day mortality predictors in the study patients.Results 1786 patients hospitalized with community-acquired pneumonia(CAP)were entered into the final analysis.The 30-day mortality was 4.7%.Logistic regression analysis confirmed blood BNP>1000 pg/ml was an independent risk factor associated with 30-day mortality of CAP patients.The area under the curve(AUC)of B-CURB65 was 0.774,which was higher than CURB-65 score(AUC=0.625,P=0.002).Conclusions Blood BNP is a valuable biomarker related to the 30-day mortality of CAP patients,which can increase the predicting accuracy of CURB-65 score.
作者
陈亮
韩秀迪
邢西迁
朱晓莉
Chen Liang;Han Xiudi;Xing Xiqian;Zhu Xiaoli(Department of Infectious Disease,Beijing Jishuitan Hospital,Beijing 100096,China;Department of Respiratory Medicine,Qingdao Municipal Hospital,Qingdao 266011,China;Department of Respiratory Medicine,Yan'an Hospital Affiliated to Kunming Medical University,Kunming 650051,China;Department of Occupational Medicine and Toxicology,Beijing Chao-Yang Hospital,Beijing 100043,China)
出处
《中国医师杂志》
CAS
2020年第1期75-79,共5页
Journal of Chinese Physician
关键词
利钠肽
脑
社区获得性肺炎
死亡率
Natriuretic peptide
brain
Community-acquired pneumonia
Mortality
