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目的:探讨血清N末端脑钠肽前体(NT-proBNP)对住院急性胰腺炎(AP)患者短期生存状况的预测价值。方法:随机选取2013年1月—2016年12月期间于我院住院治疗的AP患者82例作为观察组,另选取30例同期同龄健康查体者作为对照。采用ELISA法检测两组血清NT-proBNP水平。观察组均接受相应治疗并于治疗1、3、5、7 d和10 d后复查患者血清NT-proBNP水平。统计观察组治疗效果,并根据治疗效果分为有效组(治疗有效,n=72)和无效组(治疗无效或死亡,n=10)两个亚组。比较有效组和无效组治疗前后血清NT-proBNP水平并采用受试者操作特性曲线(ROC)分析血清NT-proBNP对住院AP患者疗效的预测价值。结果:观察组治疗前血清NT-proBNP水平为(642.35±162.45)ng/L,明显高于对照组的(43.37±11.72)ng/L;观察组血清NT-proBNP水平于治疗1 d时达到峰值,其峰值为(758.96±183.98)ng/L;观察组治疗5、7 d和10 d后血清NT-proBNP水平则较治疗前降低,差异均有统计学意义(均P<0.05)。有效组治疗前后的血清NT-proBNP水平均较无效组降低,有效组治疗5、7 d和10 d后血清NT-proBNP水平较治疗前降低,无效组治疗7 d和10 d后血清NT-proBNP水平较治疗前降低,差异均有统计学意义(均P<0.05)。血清NT-proBNP预测住院AP患者疗效的ROC曲线下面积的敏感度、特异度和准确性均较高,血清NT-proBNP预测住院AP患者疗效的价值良好。结论:血清NT-proBNP在住院AP患者中升高且在治疗无效的住院AP患者中更高;血清NT-proBNP预测住院AP患者短期生存状况的预测价值良好,因此出现血清NT-proBNP水平升高的AP患者需警惕其不良短期生存状况的发生。
Objective: To investigate the predictive value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in the short-term survival of hospitalized patients with acute pancreatitis (AP). Methods: Totally 82 AP patients hospitalized in our hospital from January 2013 to December 2016 were randomly selected as the observation group and 30 healthy people of the same age as the control group. Serum NT-proBNP levels were measured by ELISA. All the patients in the observation group received the corresponding treatment and the serum NT-proBNP levels were examined after 1, 3, 5, 7 and 10 days of treatment. The observation group was divided into two groups: effective group (effective treatment, n = 72) and ineffective group (ineffective treatment or death, n = 10) according to the therapeutic effect. The levels of serum NT-proBNP in patients before and after treatment were compared and the predictive value of serum NT-proBNP on the efficacy of inpatients with AP was analyzed by receiver operating characteristic curve (ROC). Results: The level of NT-proBNP in the observation group before treatment was (642.35 ± 162.45) ng / L, which was significantly higher than that in the control group (43.37 ± 11.72) ng / L. The serum NT-proBNP level in the observation group reached the peak at 1 d , With a peak value of (758.96 ± 183.98) ng / L. Serum NT-proBNP levels were lower in the observation group at 5, 7, and 10 d after treatment than those before treatment, with statistical differences (all P <0.05). The levels of NT-proBNP in the effective group before and after treatment were lower than those in the ineffective group. The levels of NT-proBNP in the effective group were lower than those before the treatment on the 5th, 7th and 10th day. The levels of NT-proBNP The levels were lower than before treatment, the differences were statistically significant (P <0.05). The sensitivity, specificity and accuracy of serum NT-proBNP in estimating the area under the ROC curve of inpatients with AP were high, and the value of serum NT-proBNP in predicting the efficacy of inpatients with AP was good. CONCLUSIONS: Serum NT-proBNP is elevated in hospitalized patients with AP and is higher in hospitalized AP patients with ineffective treatment; serum NT-proBNP predicts good predictive value of short-term survival in hospitalized patients with AP, resulting in an elevated serum NT-proBNP level Of AP patients should be alert to the occurrence of their poor short-term survival.