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目的:应用N氨基末端脑钠肽前体和APACHEⅡ评分评估急性心力衰竭患者近期预后。方法:选取因急性心力衰竭入院的患者51例,分为存活组(24例)、死亡组(27例),于治疗前及治疗后7d(死亡患者截止死亡前)进行APACHEⅡ评分、N氨基末端脑钠肽水平测定、床旁心脏超声检测左心室射血分数(LVEF)。观察两组患者治疗前后APACHEⅡ评分、N末端脑钠肽及左心室射血分数(LVEF)指标的变化情况。结果:两组治疗前N氨基末端脑钠肽不存在明显差异(P>0.05)的情况下,但APACHEⅡ评分存在差异(P<0.01),可以预测病死率。治疗过程中死亡率与N氨基末端脑钠肽的下降率(下降30%为界限)以及APACHEⅡ评分相关。结论:APACHEⅡ评分联合N氨基末端脑钠肽指标与急性心力衰竭危重程度相关,可以在治疗前和治疗中判断急性心力衰竭患者病死率及预后。
OBJECTIVE: To assess the short-term prognosis of patients with acute heart failure using N-terminal pro-brain natriuretic peptide and APACHE II scores. Methods: Fifty-one patients admitted to hospital due to acute heart failure were divided into survival group (n = 24) and death group (n = 27). APACHEⅡscores were measured before treatment and 7 days after treatment (dead before death) Brain natriuretic peptide levels were measured by bedside ultrasonography for left ventricular ejection fraction (LVEF). The changes of APACHEⅡscore, N-terminal brain natriuretic peptide and left ventricular ejection fraction (LVEF) before and after treatment in both groups were observed. Results: There was no significant difference (P> 0.05) between the two groups before treatment of N-terminal pro brain natriuretic peptide, but APACHE Ⅱ score difference (P <0.01), can predict mortality. Mortality during treatment was associated with a decrease in N-terminal pro-brain natriuretic peptide (a 30% reduction) and APACHE II score. Conclusion: The APACHE Ⅱ score combined with N-terminal N-terminal pro-brain natriuretic peptide is associated with the severity of acute heart failure. It can be used to determine the mortality and prognosis of patients with acute heart failure before and during treatment.