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入院时 N 末端脑利钠肽前体和肾功能对老年呼吸困难患者住院的预测价值。

Predictive value of admission N-terminal pro-B-type natriuretic peptide and renal function in older people hospitalized for dyspnoea.

机构信息

Department of Medical Sciences, Section of Clinica Medica, Azienda Ospedaliera-Universitaria "S. Anna", Ferrara, Italy.

出版信息

Dis Markers. 2013;35(6):735-40. doi: 10.1155/2013/687467. Epub 2013 Nov 14.

DOI:10.1155/2013/687467
PMID:24324290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3845254/
Abstract

BACKGROUND

We investigated the relationship between NT-pro-BNP, glomerular filtration rate (GFR), and all-cause mortality rates in a cohort of older people discharged from an internal medicine unit after admission for dyspnoea.

PATIENTS AND METHODS

NT-pro-BNP was evaluated in serum samples of 134 patients aged 80 ± 6 years who presented to a single academic centre with worsening dyspnoea. History data and anthropometric, clinical, and biochemical parameters including GFR were collected at the time of admission. 119 out of 134 were discharged alive from hospital and were included in the follow-up of 779 ± 370 days.

RESULTS

35 out of 119 subjects died after a follow-up of 266 ± 251 days. Cox proportional hazards model showed that GFR and Ln (NT-pro-BNP) were predictors for all-cause mortality with estimated hazard ratios of 0.969 (95% confidence interval: 0.950-0.988; P = 0.001) and 2.360 (95% confidence interval: 1.208-4.610; P = 0.012), respectively. Patients characterized by high NT-pro-BNP levels and GFR ≥ 60 mL/min/1.73 m(2) showed a dramatic reduction in survival duration compared with the groups with different combinations of the two variables (P = 0.008).

CONCLUSIONS

In the elderly, NT-pro-BNP and GFR are predictors of all-cause mortality after admission because of dyspnoea. Since the fact that subjects with high NT-pro-BNP and GFR ≥ 60 mL/min/1.73 m(2) exhibited a reduced survival, high admission NT-pro-BNP suggests future negative outcome.

摘要

背景

我们研究了在因呼吸困难入院的内科病房接受治疗并出院的老年患者队列中，NT-pro-BNP、肾小球滤过率（GFR）与全因死亡率之间的关系。

患者与方法

我们对 134 名年龄 80±6 岁的患者进行了血清 NT-pro-BNP 评估，这些患者因呼吸困难恶化而入住单一学术中心。入院时收集了病史数据和人体测量、临床和生化参数，包括 GFR。134 例患者中有 119 例在出院时存活，并进行了 779±370 天的随访。

结果

在 266±251 天的随访后，119 例患者中有 35 例死亡。Cox 比例风险模型显示，GFR 和 Ln（NT-pro-BNP）是全因死亡率的预测因素，估计的风险比分别为 0.969（95%置信区间：0.950-0.988；P=0.001）和 2.360（95%置信区间：1.208-4.610；P=0.012）。与两个变量不同组合的组相比，高 NT-pro-BNP 水平和 GFR≥60 mL/min/1.73 m2的患者的生存时间明显缩短（P=0.008）。

结论

在老年人中，NT-pro-BNP 和 GFR 是因呼吸困难入院后全因死亡率的预测因素。由于 NT-pro-BNP 水平高且 GFR≥60 mL/min/1.73 m2的患者生存时间缩短，入院时 NT-pro-BNP 较高提示预后不良。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4297/3845254/9ed051d189f2/DM35-06-687467.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4297/3845254/612d708341c2/DM35-06-687467.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4297/3845254/9ed051d189f2/DM35-06-687467.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4297/3845254/612d708341c2/DM35-06-687467.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4297/3845254/9ed051d189f2/DM35-06-687467.002.jpg

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