术前脑钠肽水平对预测术后呼吸并发症的影响。

Impact of preoperative brain natriuretic peptide level for predicting postoperative respiratory complications.

作者信息

Miura Kentaro, Ide Shogo, Minamisawa Masatoshi, Mishima Shuji, Nakamura Daisuke, Matsuoka Shunichiro, Kumeda Hirotaka, Eguchi Takashi, Hamanaka Kazutoshi, Kuwahara Koichiro, Shimizu Kimihiro

机构信息

Division of General Thoracic Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

J Thorac Dis. 2024 Dec 31;16(12):8389-8398. doi: 10.21037/jtd-24-1248. Epub 2024 Dec 19.

DOI:10.21037/jtd-24-1248

PMID:39831235

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11740056/

Abstract

BACKGROUND

Predicting respiratory complications after pulmonary surgery is important for thoracic surgeons. This study aimed to clarify the relationship between preoperative brain natriuretic peptide (BNP) levels and postoperative respiratory complications (PRC).

METHODS

A total of 383 patients with primary or metastatic lung cancer who underwent surgical resection were included in this retrospective study. The cut-off value of elevated BNP was set as 35 pg/mL, and its relationship with PRCs was analyzed. Risk factors for PRCs were determined using a logistic regression model.

RESULTS

Among the patients, 66 (17%) experienced PRCs: 24% 14% with BNP levels ≥35 and <35 pg/mL, respectively (P=0.02). In patients with a BNP level ≥35 pg/mL, the development of PRCs was higher in those who underwent lobectomy (34%) than in those who underwent sublobar resection (14%) (P=0.01). Univariate [odds ratio (OR): 1.947, 95% confidence interval (CI): 1.13-3.352, P=0.02] and multivariate (OR: 1.838, 95% CI: 1.032-3.273, P=0.04) analyses revealed a significant association between a preoperative BNP level ≥35 pg/mL and a higher risk of PRCs in all patients.

CONCLUSIONS

Preoperative BNP levels ≥35 pg/mL were associated with an increased risk for PRCs, suggesting its potential utility for identifying patients with elevated risk for PRCs before pulmonary surgery.

摘要

背景

预测肺手术后的呼吸并发症对于胸外科医生来说很重要。本研究旨在阐明术前脑钠肽（BNP）水平与术后呼吸并发症（PRC）之间的关系。

方法

本回顾性研究纳入了383例行手术切除的原发性或转移性肺癌患者。将BNP升高的临界值设定为35 pg/mL，并分析其与PRC的关系。使用逻辑回归模型确定PRC的危险因素。

结果

在这些患者中，66例（17%）发生了PRC：BNP水平≥35 pg/mL和<35 pg/mL的患者分别为24%和14%（P=0.02）。在BNP水平≥35 pg/mL的患者中，接受肺叶切除术的患者发生PRC的比例（34%）高于接受肺叶以下切除术的患者（14%）（P=0.01）。单因素分析[比值比（OR）：1.947，95%置信区间（CI）：1.13 - 3.352，P=0.02]和多因素分析（OR：1.838，95% CI：1.032 - 3.273，P=0.04）显示，术前BNP水平≥35 pg/mL与所有患者发生PRC的较高风险之间存在显著关联。