摘要
目的探讨重症肺炎所致急性呼吸窘迫综合征(ARDS)患者血清心肌肌钙蛋白Ⅰ(cTnⅠ)、氨基末端脑钠肽前体(NT-proBNP)及C反应蛋白(CRP)水平变化及临床意义。方法2017年12月-2019年12月收治102例的重症肺炎所致ARDS患者设为观察组(轻度35例、中度37例、重度30例),选取同期在本院进行体检的110例健康者作为对照组。比较各组之间cTnⅠ、NT-proBNP、CRP水平,对观察组患者随访1年,并比较不同cTnⅠ、NT-proBNP、CRP表达的患者预后情况。绘制ROC曲线,分析三者单独及联合检测对重症肺炎所致ARDS患者预后不良的预测价值。结果观察组cTnⅠ、NT-proBNP及CRP水平均明显高于对照组,差异有统计学意义(P<0.05)。cTnⅠ、NT-proBNP、CRP水平:轻度组<中度组<重度组,各组间比较差异有统计学意义(P<0.05)。cTnⅠ、NT-proBNP、CRP异常增高的重症肺炎所致的ARDS患者死亡率明显高于cTnⅠ、NT-proBNP、CRP正常表达的患者,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,联合cTnⅠ、NT-proBNP、CRP三者检测灵敏度、特异度最大,为0.871、0.880。结论临床可加强cTnⅠ、NT-proBNP、CRP三者联合检测,以评估重症肺炎所致ARDS患者病情进展、预测预后。
Objective To explore the level changes and clinical significance of serum cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP)and C-reactive protein(CRP)of patients with acute respiratory distress syndrome(ARDS)caused by severe pneumonia. Methods 102 patients with ARDS caused by severe pneumonia treated in this hospital from December 2017 to December 2019 were selected as the observation group(35 cases with mild ARDS,37 cases with moderate ARDS,and 30 cases with severe ARDS). 110 healthy people who had physical examination in this hospital during the same period were selected as the control group. The levels of cTnⅠ,NT-proBNP and CRP between the groups were compared.Patients in the observation group were followed up for 1 year,and the prognosis of patients with different expressions of cTnⅠ,NT-proBNP and CRP were compared. The ROC curve was drawn to analyze the predictive value of the three separate and combined tests on the poor prognosis of ARDS patients caused by severe pneumonia. Results The cTnⅠ,NT-proBNP and CRP levels in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). The levels of cTnⅠ,NT-pro BNP and CRP :the mild group <the moderate group < the severe group,and the differences between the groups were statistically significant(P<0.05). The mortality of ARDS patients caused by severe pneumonia with abnormal increasing of cTnⅠ,NT-pro BNP and CRP was significantly higher than that of patients with normal expression of cTnⅠ,NT-pro BNP and CRP,and the difference was statistically significant(P<0.05). The results of ROC curve analysis showed that the sensitivity and specificity of the combined detection of cTnⅠ,NT-pro BNP and CRP were the highest,which were 0.871 and 0.880. Conclusion Clinically,the combined detection of cTnⅠ,NT-pro BNP,and CRP can be strengthened to assess the disease progression and predict the prognosis of ARDS patients caused by severe pneumonia.
作者
刘春
邹勇
郭燕
陶琳
王晓春
LIU Chun;ZOU Yong;GUO Yan;TAO lin;WANG Xiaochun(Jiangdi First Aid Station of the Fifth Hospital of Wuhan,Wuhan,Hubei,China,430050;Wuhan Emergency Center,Wuhan,Hubei,China,430020;Emergency Department of the Fifth Hospital of Wuhan,Wuhan,Hubei,China,430050)
出处
《分子诊断与治疗杂志》
2021年第7期1154-1157,共4页
Journal of Molecular Diagnostics and Therapy
基金
湖北省卫生计生委应用基础研究计划面上项目(WX17D15)。
