不同类型休克患者的肺动脉收缩压对预后的诊断价值

摘要
图/表
参考文献(18)
相关文章 (12)

全文: PDF (0 KB) HTML (37 KB)
输出: BibTeX | EndNote (RIS)

摘要目的观察不同类型休克患者的肺动脉收缩压（PASP）评估PASP 对休克患者死亡的预测价值。方法回顾性分析2017年1月～2018年12月江门市中心医院收治的155 例休克患者的临床资料。根据休克类型分为感染性休克组（93 例）、心源性休克组（21 例）、低血容量性休克组（41 例）。检测患者的血乳酸（LAC）、N 末端B 型利钠肽原（NT-proBNP）、白细胞计数（WBC）的水平以及PASP 的数值。结果感染性休克组PASP、NT-proBNP、死亡率高于低血容量性休克组，差异有统计学意义（P<0.05）；感染性休克组NT-proBNP 低于心源性休克组，差异有统计学意义（P<0.05）；心源性休克组NT-proBNP、死亡率高于低血容量性休克组，差异有统计学意义（P<0.05）；PASP 与NT-proBNP 呈正相关（r=0.289，P<0.05），PASP 与LAC 无相关性（P>0.05）；受试者工作特征（ROC）曲线分析结果显示，休克患者PASP 死亡预测价值优于LAC 及NT-proBNP（P<0.05）。结论 PASP 是休克患者有效的死亡预测指标，可以更好地识别休克的发生与发展，提高重症医学科患者的抢救成功率，值得在临床中推广及运用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	蔡雪敏
	郑伟浩
	张爽
	李超梁

关键词 ：感染性休克, 心源性休克, 低血容量性休克, 肺动脉收缩压, 血乳酸, N 末端B 型利钠肽原

Abstract：Objective To observe pulmonary artery systolic pressure (PASP) of patients with different types of shock and evaluate the predictive value of PASP for death in shock patients. Methods The clinical data of 155 patients with shock who were admitted to Jiangmen Central Hospital from January 2017 to December 2018 were retrospectively analyzed. According to the type of shock, they were divided into septic shock group (93 cases), cardiogenic shock group(21 cases) and hypovolemic shock group (41 cases). The levels of blood lactate (LAC), N-terminal pro-B-type natriuretic peptide (NT-proBNP), white blood cell count (WBC) as well as the values of PASP in the patients were detected.Results PASP, NT-proBNP and mortality of the septic shock group were higher than those in hypovolemic shock group,the differences were statistically significant (P<0.05). NT-proBNP was lower than that in cardiogenic shock group, the difference was statistically significant (P<0.05). NT-proBNP and mortality in cardiogenic shock group were higher than those in hypovolemic shock group, the differences were statistically significant (P<0.05). PASP was positively correlated with NT-proBNP (r=0.289, P<0.05), while PASP was not correlated with LAC (P>0.05). Receiver operating characteristic (ROC) curve analysis results showed that PASP had better predictive value than NT-proBNP and LAC (P<0.05).Conclusion PASP is an effective death prediction index for patients with shock, which can better identify the occurrence and development of shock and improve the success rate of rescue of patients in critical medicine department. It is worthy of promotion and application in clinical practice.

Key words： Septic shock Cardiogenic shock Hypovolemic shock Pulmonary arterial systolic pressure Blood lactate;N-type brain natriuretic peptide

引用本文:

蔡雪敏；郑伟浩；张爽；李超梁. 不同类型休克患者的肺动脉收缩压对预后的诊断价值[J]. 中国当代医药, 2021, 28(3): 58-61.
CAI Xue-min ；ZHENG Wei-hao ；ZHANG Shuang ；LI Chao-liang. Diagnostic value of pulmonary arterial systolic blood pressure for prognosis in patients with different types of shock. 中国当代医药, 2021, 28(3): 58-61.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I3/58

[1]	Vincent JL，De Backer D.Circulatory shock[J].N Engl J Med，2013，369（18）：1726-1734.
[2]	王小亭，刘大为，张宏民，等.重症右心功能管理专家共识[J].中华内科杂志，2017，56（12）：962-973.
[3]	Barberà JA，Román A，Gómez-Sánchez MA，et al.Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension:Summary of Recommendations[J].Arch Bronconeumol，2018，54（4）：205-215.
[4]	中华医学会心血管病学分会肺血管病学组，中华心血管病杂志编辑委员会.中国肺高血压诊断和治疗指南2018[J].中华心血管病杂志，2018，46（12）：933-964.
[5]	Mamazhakypov A，Viswanathan G，Lawrie A，et al.The role of chemokines and chemokine receptors in pulmonary arterial hypertension[J].Br J Pharmacol，2021，178（1）：72-89.
[6]	Guazzi M，Naeije R.Pulmonary Hypertension in Heart Failure：Pathophysiology，Pathobiology，and Emerging Clinical Perspectives[J].J Am Coll Cardiol，2017，69（13）：1718-1734.
[7]	Hoeper MM，Ghofrani HA，Grünig E，et al.Pulmonary Hypertension[J].Dtsch Arztebl Int，2017，114（5）：73-84.
[8]	Kim CW，Aronow WS，Dutta T，et al.Pulmonary Artery Denervation as an Innovative Treatment for Pulmonary Hypertension with and without Heart Failure[J].Cardiol Rev，2020.
[9]	Tartavoulle TM.Management of Sepsis in Patients with Pulmonary Arterial Hypertension in the Intensive Care Unit[J].Crit Care Nurs Clin North Am，2017，29（1）：15-23.
[10]	Seymour CW，Rosengart MR.Septic Shock：Advances in Diagnosis and Treatment[J].JAMA.2015，314（7）：708-717.
[11]	Korff S，Enders-Gier P，Uhlmann L，et al.Systolic pulmonary artery pressure assessed during routine exercise Doppler echocardiography：insights of a real-world setting in patients with elevated pulmonary pressures[J].Int J Cardiovasc Imaging，2018，34（8）：1215-1225.
[12]	Vallabhajosyula S，Geske JB，Kumar M，et al.Doppler-defined pulmonary hypertension in sepsis and septic shock[J].J Crit Care，2019，50，201-206.
[13]	Hachulla E，Clerson P，Airò P，et al.Value of systolic pulmonary arterial pressure as a prognostic factor of death in the systemic sclerosis EUSTAR population[J].Rheumatology（Oxford），2015，54（7）：1262-1269.
[14]	Tang M，Batty JA，Lin C，et al.Pulmonary Hypertension，Mortality，and Cardiovascular Disease in CKD and ESRD Patients： A Systematic Review and Meta-analysis[J].Am J Kidney Dis，2018，72（1）：75-83.
[15]	Matsushita K，Sakata K，Satoh T，et al.Estimated Pulmonary Artery Systolic Pressure and Mortality in Older-Elderly Heart Failure Patients[J].J Am Geriatr Soc，2019，67（2）：323-328.
[17]	王平，张丽涓，周贵，等.肺动脉压与脑钠肽对脓毒性休克患者预后的价值[J].中华医学杂志，2015，95（27）：2194-2197.
[18]	戎群芳，张育才，徐梁，等.重症肺炎并呼吸衰竭患儿动态无创肺动脉压力监测及其意义[J].中华实用儿科临床杂志，2015，30（4）：271-274.
[16]	Cheng H，Fan WZ，Wang SC，et al.N-terminal pro-brain natriuretic peptide and cardiac troponin I for the prognostic utility in elderly patients with severe sepsis or septic shock in intensive care unit：A retrospective study[J].J Crit Care，2015，30（3），654.