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NT-proBNP 在因败血症休克而到急诊就诊的患者中作为预后因素的临床作用。

Clinical usefulness of NT-proBNP as a prognostic factor for septic shock patients presenting to the emergency department.

机构信息

Chung-Ang University Gwangmyeong Hospital, Deokan-ro 110, Gwangmyeong-si, Gyeonggi-do, 14353, Republic of Korea.

Department of Emergency Medicine, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.

出版信息

Sci Rep. 2024 May 14;14(1):10999. doi: 10.1038/s41598-024-61888-5.

Abstract

Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) level is primarily used as a biomarker for left ventricular (LV) dysfunction. It is influenced by various conditions, such as myocardial strain and situations affecting the clearance of NT-proBNP, including sepsis and shock. In this study, we investigated the appropriateness of NT-proBNP as a prognostic factor for septic shock. Patients with septic shock who visited the emergency department of the Ewha Womans' University Mokdong Hospital between January 1, 2018, and December 31, 2020, were classified into the survival group (those who survived in the hospital and were discharged) and the death group (those who died in the hospital). The effectiveness of NT-proBNP, lactate, and blood urea nitrogen as predictive factors of in-hospital mortality was evaluated using the area under the receiver operating characteristic (AUROC) curve. The AUROC curve was 0.678 and 0.648 for lactate and NT-proBNP, respectively, with lactate showing the highest value. However, there was no significant difference between lactate and NT-proBNP levels in the comparison of their AUROC curve (p = 0.6278). NT-proBNP could be a useful predictor of in-hospital mortality in patients with septic shock who present to the emergency department.

摘要

血浆脑钠肽前体 N 端(NT-proBNP)水平主要用作左心室(LV)功能障碍的生物标志物。它受多种因素影响,如心肌应变和影响 NT-proBNP 清除的情况,包括败血症和休克。在这项研究中,我们调查了 NT-proBNP 作为败血症性休克预后因素的适宜性。2018 年 1 月 1 日至 2020 年 12 月 31 日期间,在韩国梨花女子大学木洞医院急诊就诊的败血症性休克患者被分为存活组(在医院存活并出院)和死亡组(在医院死亡)。使用受试者工作特征(ROC)曲线下面积(AUROC)评估 NT-proBNP、乳酸和血尿素氮作为预测院内死亡率的有效性。乳酸和 NT-proBNP 的 AUROC 曲线分别为 0.678 和 0.648,乳酸的 AUROC 曲线值最高。然而,在比较其 AUROC 曲线时,乳酸和 NT-proBNP 水平之间没有显著差异(p=0.6278)。NT-proBNP 可能是败血症性休克患者就诊于急诊科时院内死亡率的有用预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d92/11094059/61e34b2d3203/41598_2024_61888_Fig1_HTML.jpg

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