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术前预后营养指数联合 NT-proBNP 预测先天性心脏病患儿急性肾损伤的价值。

Value of preoperative prognostic nutritional index combined with NT-proBNP in predicting acute kidney injury of congenital heart disease children.

机构信息

Cardiovascular Surgery, Qingdao Cardiovascular Hospital, Qingdao, Shandong, China.

出版信息

PeerJ. 2024 Sep 18;12:e18085. doi: 10.7717/peerj.18085. eCollection 2024.

Abstract

OBJECTIVE

The study investigates value of preoperative prognostic nutritional index (PNI) combined with N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting postoperative acute kidney injury (AKI) in congenital heart disease (CHD) children.

METHODS

The clinical data of 108 children with congenital heart disease were retrospectively collected. According to whether AKI occurred 48 h after operation, they were divided into AKI group ( = 32) and non-AKI group ( = 76). The clinical data, preoperative PNI and NT-proBNP levels were compared between the two groups. Multivariate logistic regression analysis was used to analyze the influencing factors of AKI, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of preoperative PNI, NT-proBNP and their combination.

RESULTS

Multivariate logistic regression analysis showed that Scr, PNI and NT-proBNP were independent risk factors for postoperative AKI in children with congenital heart disease ( < 0.001). The results of ROC curve analysis showed that the area under the curve () of preoperative PNI, NT-proBNP and their combination in predicting postoperative AKI in children with congenital heart disease were 0.839, 0.738 and 0.907, respectively, and the AUC of their combination was the highest.

CONCLUSION

The combined use of preoperative PNI as well as NT-proBNP holds significant value in predicting postoperative AKI in CHD children. Monitoring preoperative PNI and NT-proBNP levels may aid in clinically identifying the risk of postoperative AKI in CHD children, thereby improving their prognosis.

摘要

目的

本研究旨在探讨术前预后营养指数(PNI)联合 N 末端脑利钠肽前体(NT-proBNP)对预测先天性心脏病(CHD)患儿术后急性肾损伤(AKI)的价值。

方法

回顾性收集 108 例先天性心脏病患儿的临床资料。根据术后 48 小时是否发生 AKI,将患儿分为 AKI 组(n=32)和非 AKI 组(n=76)。比较两组患儿的临床资料、术前 PNI 和 NT-proBNP 水平。采用多因素 logistic 回归分析 AKI 的影响因素,并绘制受试者工作特征(ROC)曲线评估术前 PNI、NT-proBNP 及其联合预测先天性心脏病患儿术后 AKI 的价值。

结果

多因素 logistic 回归分析显示,Scr、PNI 和 NT-proBNP 是儿童先天性心脏病术后 AKI 的独立危险因素(<0.001)。ROC 曲线分析结果显示,术前 PNI、NT-proBNP 及其联合预测儿童先天性心脏病术后 AKI 的曲线下面积(AUC)分别为 0.839、0.738 和 0.907,联合预测的 AUC 最高。

结论

术前 PNI 联合 NT-proBNP 对预测 CHD 患儿术后 AKI 具有重要价值。监测术前 PNI 和 NT-proBNP 水平可能有助于临床识别 CHD 患儿术后 AKI 的风险,从而改善患儿的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e805/11416089/423e7b6156fe/peerj-12-18085-g001.jpg

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