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目的 探讨B型脑钠肽作为社区获得性肺炎预后指标的价值.方法 本研究为多中心、回顾性研究.收集2014年1月1日至2015年12月31日在北京、青岛和昆明四家三级医院住院的社区获得性肺炎(CAP)患者的临床资料,包括人口学特征、临床症状体征、实验室检查和影像学资料.单因素分析法和logistic回归分析法探讨与CAP 30 d病死率相关的危险因素.受试者工作曲线(ROC)评价血浆B型脑钠肽(BNP)＞1 000 pg/ml、英国胸科协会改良肺炎评分(CURB-65评分)以及血浆BNP＞1 000 pg/ml+ CURB-65评分(B-CURB65)对CAP 30 d死亡风险的预测能力.结果 共有1 786例CAP患者纳入最后分析,30 d病死率4.7％(84/1 786).Logistic回归分析证实血浆BNP＞1 000 pg/ml是CAP患者30 d死亡的独立危险因素(OR=2.624,P=0.001,95％ CI:1.496～4.601).B-CURB65预测CAP 30 d死亡其曲线下面积(AUC)为0.774,高于CURB-65评分(AUC=0.625,P=0.002).结论 BNP是一个有价值的与CAP预后相关的生物学标志物;联合CURB-65评分能显著增加对CAP 30 d死亡风险的预测能力.“,”Objective To explore the value of B-type natriuretic peptide (BNP) be used as a prognostic factor for community-acquired pneumonia.Methods This was a multicenter,retrospective study.Data of patients hospitalized with community-acquired pneumonia during 2014/1/1 to 2015/12/31 from four tertiary hospitals were reviewed,including demographic and clinical features,and outcomes.Univariate analysis and logistic regression analysis were performed to determine risk factors for 30-day mortality.Receiver operating characteristic curves (ROCs) was performed to verify the accuracy of BNP ＞ 1 000 pg/ml,CURB-65 score and BNP ＞ 1 000 pg/ml + CURB-65 score (B-CURB65) as 30-day mortality predictors in the study patients.Results 1 786 patients hospitalized with community-acquired pneumonia (CAP) were entered into the final analysis.The 30-day mortality was 4.7％.Logistic regression analysis confirmed blood BNP ＞ 1 000 pg/ml was an independent risk factor associated with 30-day mortality of CAP patients.The area under the curve (AUC) of B-CURB65 was 0.774,which was higher than CURB-65 score (AUC =0.625,P =0.002).Conclusions Blood BNP is a valuable biomarker related to the 30-day mortality of CAP patients,which can increase the predicting accuracy of CURB-65 score.