摘要
目的研究老年急性胰腺炎患者心肌功能障碍及其对预后的影响。方法选择2015年1月1日~2019年12月31日我院重症急性胰腺炎专病中心收治的老年急性胰腺炎患者62例,根据预后分为生存组43例和死亡组19例。收集患者入院心肌生物学指标及生命体征,ICU住院时间和预后,比较2组患者的差异,并分析预后相关因素。结果62例患者中,死亡19例,病死率30.6%。与存活组比较,死亡组年龄、ICU住院时间、呼吸、肌钙蛋白T、肌酸激酶、肌酸激酶同工酶、肌红蛋白、N末端B型钠尿肽前体(NT-proBNP)、C反应蛋白和中性粒细胞百分比明显增高,差异有统计学意义(P<0.05,P<0.01)。死亡组患者多变量回归分析中,肌红蛋白>75μg/L(OR=4.222,95%CI:1.001~22.627,P=0.049)和NT-proBNP>300 ng/L(OR=11.399,95%CI:1.122~115.648,P=0.040)为患者生存的独立危险因素。结论老年胰腺炎患者更易发生心肌损伤,肌红蛋白和NT-proBNP升高为老年急性胰腺炎患者生存的独立危险因素。
Objective To study the effect of myocardial dysfunction on the outcome in elderly acute pancreatitis patients.Methods Sixty-two elderly acute pancreatitis patients admitted to our hospital from January 2015 to December 2019 were divided into survival group(n=43)and death group(n=19).Their myocardial biological indicators and vital signs on admission,ICU stay time and outcome were recorded and compared.Their outcome-related factors were analyzed.Results Of the 62 elderly acute pancreatitis patients included in this study,19 died with a mortality of 30.6%.The age was significantly older,the ICU stay time was significantly longer,the respiration rate,serum levels of troponin T,creatine kinase,creatine kinase isoenzyme MB,myoglobin,NT-proBNP,CRP and percentage of neutrophils were significantly higher in death group than in survival group(P<0.05,P<0.01).Multivariate logistic regression analysis showed that myoglobin>75μg/L and NT-proBNP>300 ng/L were the independent risk factors for survival in elderly acute pancreatitis patients(OR=4.222,95%CI:1.001-22.627,P=0.049;OR=11.399,95%CI:1.122-115.648,P=0.040).Conclusion Elderly acute pancreatitis patients are susceptbile to myocardial injury.Elevated serum myoglobin and NT-proBNP levels are the independent risk factors for survival in elderly acute pancreatitis patients.
作者
赵永生
寇佳琪
孔令雪
李欣欣
赵庆华
任为正
何蕾
Zhao Yongsheng;Kou Jiaqi;Kong Lingxue;Li Xinxin;Zhao Qinghua;Ren Weizheng;He Lei(Department of Hepatobiliary and Pancreatic Surgery,Chinese PLA General Hospital No.1 Medical Center,Beijing 100853,China)
出处
《中华老年心脑血管病杂志》
北大核心
2021年第7期700-703,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
北京市自然科学基金(7194317)。
