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目的:探讨脑钠肽对心跳骤停患者28天生存率的预测价值。方法:回顾分析2013年1月至2016年1月共74例东莞厚街医院、中山大学附属东华医院急诊接诊心跳骤停患者资料。根据28天预后,分为存活组(n=43)和死亡组(n=31)。应用受试者工作特征曲线分别对自主循环恢复时间、APACHEⅡ、cTnI、CK-MB、NT-ProBNP进行评价。结果:两组患者性别、年龄、原发病均无显著统计学差异(P>0.05)。存活组自主循环恢复时间和NT-ProBNP均显著低于死亡组(P均<0.05)。自主循环恢复时间和NT-ProBNP ROC曲线下面积分别为0.837(95%CI:0.740-0.933)和0.845(95%CI:0.756-0.933)。NT-ProBNP对院前心跳骤停患者28天生存率的预测价值的预测价值优于自主循环恢复时间。当NT-ProBNP取临界值2500.5 ng/L时,敏感性和特异性分别为93.5%和58.1%。结论:NT-ProBNP对院前心跳骤停患者28天生存率的预测价值的预测价值优于自主循环恢复时间,可做为评估心跳骤停患者预后的筛查指标。
Objective: To investigate the predictive value of brain natriuretic peptide in 28-day survival rate in patients with cardiac arrest. Methods: A retrospective analysis of 74 cases of Dongguan Houjie Hospital from Jan. 2013 to January 2016 was conducted. Emergency patients were admitted to Tung Wah Hospital. According to the 28-day prognosis, survival group (n = 43) and death group (n = 31) were divided. The recovery time of spontaneous circulation, APACHEⅡ, cTnI, CK-MB and NT-ProBNP were evaluated using the working curve of the subjects. Results: There was no significant difference in gender, age and primary disease between the two groups (P> 0.05). The recovery time and NT-ProBNP in survival group were significantly lower than those in death group (all P <0.05). The area under the ROC and NT-ProBNP ROC curves were 0.837 (95% CI: 0.740-0.933) and 0.845 (95% CI: 0.756-0.933), respectively. The predictive value of NT-ProBNP in predicting the 28-day survival rate of patients with pre-hospital cardiac arrest is superior to that of spontaneous circulation recovery time. When NT-ProBNP was taken as the cutoff value of 2500.5 ng / L, the sensitivity and specificity were 93.5% and 58.1%, respectively. CONCLUSION: The predictive value of NT-ProBNP in predicting the 28-day survival rate of patients with pre-hospital cardiac arrest is superior to that of spontaneous circulation recovery and can be used as a screening index to evaluate the prognosis of patients with cardiac arrest.