【摘要】 目的:探究血浆NT-proBNP水平与髋部骨折严重程度与预后的相关性分析。方法:选取2016年5月～2019年2月我院收治的72例髋部骨折患者作为研究对象。根据治疗方法不同分为手术组和保守治疗组;根据半年预后分为死亡组和生存组;根据患者体质对手术危险性分为ASAⅠ、Ⅱ、Ⅲ、Ⅳ级;根据血浆NT-proBNP水平分为正常组、低水平组、中等水平组、高水平组。观察并记录患者血浆NT-proBNP值、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、ASA分级、随访半年生死率。结果:髋部骨折患者血浆NT-proBNP水平和APACHE Ⅱ评分具有显著正相关。手术组血浆NT-proBNP水平、NT-proBNP异常、APACHE Ⅱ评分、半年病死率明显低于保守治疗组。生存组年龄、血浆NT-proBNP水平、APACHE Ⅱ评分明显低于死亡组。随着ASA级别升高,NT-proBNP水平、半年病死率明显升高,组间比较差异具有统计学意义。随着NT-proBNP水平升高,APACHE Ⅱ评分、半年病死率明显升高,组间比较差异具有统计学意义。血浆 NT-proBNP水平评估老年髋部骨折患者预后的AUC为0.982;当截点值为1281.54pg/mL时,特异度为90.65%。结论:髋部骨折患者血浆NT-proBNP水平与病情严重程度呈正相关,有利于评估术前风险,预测患者预后。更多还原

【Abstract】 Objective To investigate the correlation between plasma NT-proBNP level and severity & prognosis of hip fracture.Methods 72 patients with hip fracture admitted in our hospital from May 2016 to February 2019 were divided into operation group and conservative treatment group according to different treatment methods,into death group and survival group according to the half-year prognosis,classified into ASAI,II,III and IV according to risk of the patient’s physical condition to surgery;into normal group,low level group,medium level group,high level group according to plasma NT-proBNP level.The patient’s plasma NT-proBNP value,Acute Physiology And Chronic Health Evaluation II (APACHE II),ASA grade and half-year follow-up rate were observed and recorded.Results The plasma NT-proBNP level was positively correlated with APACHE II score in patients with hip fracture.Plasma NT-proBNP levels,NT-proBNP abnormalities,APACHE II scores and half-year mortality were significantly lower in the operation group than those in the conservative treatment group.The age,plasma NT-proBNP level and APACHE II score were significantly lower in survival group than in death group.With the increase of ASA level,the level of NT-proBNP and half-year mortality increased significantly,and the difference between the groups was statistically significant.With the increase of NT-proBNP level,APACHE II score and half-year mortality increased significantly.Plasma NT-proBNP levels were evaluated in patients with hip fractures with an AUC of 0.982.When the cut-off value was 1281.54 pg/mL,specificity 90.65%.Conclusion The level of plasma NT-proBNP in patients with hip fracture is positively correlated with the severity of the disease,which is helpful to evaluate the preoperative risk and predict the prognosis in patients.更多还原