Int J Cardiol：先天性心脏病手术患儿B型利钠肽前体N末端水平的变化及临床预后

2019-02-16 xing.T 网络

由此可见，升高的NT-proBNP可能是接受心脏手术的冠心病患儿不良预后的有用标志。

近日，心血管领域权威杂志International Journal of Cardiology上发表了一篇研究文章，该研究旨在探讨先天性心脏病（CHD）手术后B型利钠肽前体N末端（NT-proBNP）变化与患者预后的关系。

在心脏手术之前和之后的1、12、36和72小时测量了873名儿童的NT-proBNP水平。患者在术后30、90和180天进行随访。感兴趣的临床结局包括长期重症监护病房（ICU）停留（>3天）、机械通气时间延长（>48h）和不良事件发生（即死亡、再入院和感染）。

手术后NT-proBNP增加，12h达到峰值，之后逐渐下降。NT-proBNP中位数变化（即术前减去术后72小时水平）为-1212.68pg/mL（四分位数范围为-3099.87至-66.81）。29.4％的患者发生不良事件。多因素logistic回归分析显示，较低的体表面积（BSA）、较高的先天性心脏手术风险调整-1评分和较小的年龄与长期ICU住院和机械通气的风险增加显著相关。NT-proBNP的减少或轻微增加与较低的风险相关。在多变量cox回归中，NT-proBNP的减少或轻微增加与较低的死亡风险相关。除了NT-proBNP变化的四分位数外，BSA还是不良事件的重要预测因子。根据受限制的三次样条模型，延长ICU停留和机械通气的关联是U形的。NT-proBNP变化与死亡之间的关联尚无定论。

由此可见，升高的NT-proBNP可能是接受心脏手术的冠心病患儿不良预后的有用标志。

原始出处：

Ramit KumarGupta,et al.Change in N-terminal pro B-type natriuretic peptide levels and clinical outcomes in children undergoing congenital heart surgery.International Journal of Cardiology.2019.https://www.sciencedirect.com/science/article/pii/S0167527318354032

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2019-05-05 12499e01m47暂无昵称

#Cardiol#

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2019-11-06 839640791

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2019-04-07 ms7421025882867189

#B型利钠肽前体N末端#

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2019-02-18 tonychen21

#利钠肽#

67 0
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2019-02-18 huirong

#先天性#

69 0
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2019-02-18 budeshao

#临床预后#

74 0
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2019-02-16 ylzr123

好文章，点赞啦！认真学习，谢谢分享给广大同好！

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