摘要
目的:探讨脑脊液中乳酸联合血肌钙蛋白I (cTnI)、N末端脑钠肽前体(NT-proBNP)水平对动脉瘤性蛛网膜下腔出血(aSAH)患者预后的评估价值。方法:选择80例aSAH患者,检测并记录患者发病后第1、3、7天脑脊液乳酸浓度,收集患者血常规、肝肾功能、心肌酶、血气分析等指标。3个月后对患者进行随访,根据格拉斯哥预后评分将其分为预后良好组和预后不良组,比较2组患者以上指标,绘制受试者工作特征(ROC)曲线,分析脑脊液乳酸联合血cTnI、NT-proBNP对预后的评估价值。结果:80例患者中预后良好45例,预后不良35例。预后良好组第1、3天脑脊液乳酸浓度明显低于预后不良组(P<0.05),ROC曲线分析显示第1天脑脊液乳酸浓度对aSAH预后的评估效能优于第3天、第7天,曲线下面积(AUC)分别为0.842、0.657、0.533。预后良好组患者血尿素氮、血糖、pH、cTnI、NT-proBNP明显低于预后不良组(P均<0.05),ROC曲线分析显示第1天脑脊液乳酸浓度联合血cTnI、NT-proBNP对预后的评估效能最高,AUC为0.94,灵敏度88.6%,特异性88.9%,优于尿素氮、血糖、pH及单项cTnI和NT-proBNP。结论:脑脊液中乳酸浓度联合血cTnI、NT-proBNP水平对aSAH预后有较高的预测价值。
Objective:To investigate the predictive value of cerebrospinal fluid(CSF) lactate combined with blood troponin I(CTnI) and N-terminal brain natriuretic peptide precursor(NT-proBNP) levels in the prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods:A total of 80 patients with aSAH were selected,and the lactate concentration in CSF on the 1st,3rd,and 7th day after the onset of the disease was detected and recorded,and the patients' blood routine,liver and kidney function,cardiac enzymes,blood gas analysis and other indicators were collected.After 3 months,the patients were followed up,and according to the Glasgow prognostic score,they were divided into good prognosis group and poor prognosis group.The above indexes of the two groups were compared,the receiver operating characteristic(ROC) curve was plotted,and the prognostic value of CSF lactate combined with blood CTnI and NT-proBNp was analyzed.Results:Among the 80 patients,45 had a good prognosis and 35 had a poor prognosis.The CSF lactate concentration on the first and third day in the good prognosis group was significantly lower than that in the poor prognosis group(P<0.05),and the ROC curve analysis showed that the predictive efficacy of the CSF lactate concentration on the first day was better than that on the third and 7th day,and the area under the curve(AUC) was 0.842,0.657 and 0.533,respectively.The blood urea nitrogen,blood glucose,pH,CTnI and NT-proBNp in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05),and the ROC curve analysis showed that the CSF lactate concentration combined with blood CTnI and NT-proBNp on the first day had the highest prognostic evaluation performance,with an AUC of 0.94,a sensitivity of 88.6% and a specificity of 88.9%,which were better than urea nitrogen,blood glucose,pH and individual CTnI and NT-proBNp.Conclusion:The concentration of lactate in CSF combined with the levels of CTnI and NT-proBNp in blood has a high predictive value in the prognosis of aSAH
作者
康寿磊
李金秀
荣风燕
李亚霖
王文涛
KANG Shou-lei;LI Jin-xiu;RONG Feng-yan;LI Ya-lin;WANG Wen-tao(Department of Critical Care Medicine,Liaocheng Second People's Hospital Affiliated to Shandong First Medical University,Shandong Linging 252600,China)
出处
《内科急危重症杂志》
2024年第1期51-54,74,共5页
Journal of Critical Care In Internal Medicine
关键词
动脉瘤性蛛网膜下腔出血
脑脊液
乳酸
肌钙蛋白Ⅰ
N末端脑钠肽前体
Aneurysmal subarachnoid hemorrhage
Cerebrospinal fluid lactate concentration
Troponin I
N-terminal brain natriuretic peptide precursor
