影像科学与光化学 ›› 2021, Vol. 39 ›› Issue (1): 61-66.DOI: 10.7517/issn.1674-0475.200617

• 综述与论文 • 上一篇    下一篇

心脏及膈肌活动度超声联合血清NT-proBNP对有创机械通气患者撤机结局的预测价值

贾松1, 文海燕1, 吴萍2, 刘冬辉1, 侯丽彦1, 赵影1   

  1. 1. 保定市第二中心医院 重症医学科, 河北 保定 072750;
    2. 保定市第二中心医院 新生儿科, 河北 保定 072750
  • 收稿日期:2020-06-30 发布日期:2021-01-13
  • 通讯作者: 贾松

The Predictive Value of Cardiac Ultrasound and Diaphragmatic Activity Ultrasound Combined with Serum NT-proBNP in Patients with Invasive Mechanical Ventilation

JIA Song1, WEN Haiyan1, WU Ping2, LIU Donghui1, HOU Liyan1, ZHAO Ying1   

  1. 1. Intensive Care Unit, Baoding No.2 Central Hospital, Baoding 072750, Hebei, P. R. China;
    2. New Pediatric Department, Baoding No.2 Central Hospital, Baoding 072750, Hebei, P. R. China
  • Received:2020-06-30 Published:2021-01-13

摘要: 为探究超声心动图(TTE)、膈肌活动度(DE)超声及血清N-末端脑钠肽前体(NT-proBNP)检测三者联合对有创机械通气患者撤机结局的预测价值,本研究选取行有创机械通气的呼吸衰竭患者85例,分别行TTE超声检查、DE超声及自主呼吸实验(spontaneous breathing trial,SBT),观察患者撤机结局。结果显示,85例患者中,撤机失败者占30.59%,撤机成功者占69.41%。SBT后撤机失败组患者的E、E/e'、NT-proBNP高于撤机成功组(P<0.05),DE值低于撤机成功组(P<0.05)。二元Logistic回归分析显示,E/e'、DE、NT-proBNP均为有创机械通气患者撤机结局的影响因素(P<0.05);另ROC曲线显示,E/e'、DE、NT-proBNP三项联合预测撤机失败的AUC为0.989,高于单项检测。本研究提示心脏及DE超声联合血清NT-proBNP对有创机械通气患者撤机结局的预测价值较高。

关键词: 超声心动图, 膈肌活动度, NT-proBNP, 有创机械通气, 撤机

Abstract: The purpose of this article is to explore the value of echocardiography (TTE), phrenic activity (DE) ultrasound and serum N-terminal brain natriuretic peptide precursor (NT-proBNP) in predicting the outcome of patients with invasive mechanical ventilation after extubation. In this study, 85 patients undergoing invasive mechanical ventilation due to respiratory failure were selected as the research group. TTE ultrasound examination, DE ultrasound examination and SBT test were performed respectively to observe the outcome of patients after extubation. The results showed that among the 85 patients, 30.59% were unsuccessful and 69.41% were successful. After the SBT test, the E, E/e' and NT-proBNP values of the failed extubation group were higher than those of the successful extubation group (P<0.05), while DE value was lower than that of the successful extubation group (P<0.05). Binary logistic regression analysis showed that E/e', DE and Nt-proBNP were all influencing factors (P<0.05). In addition, the ROC curve showed that the the combined AUC of E/e', DE, NT-proBNP predicting the failure was 0.989, which was higher than any single test. It suggested that the predictive value of cardiac and DE ultrasound combined with serum NT-proBNP for successful extubation of patients with invasive mechanical ventilation was relatively high.

Key words: echocardiography, diaphragmatic activity, NT-proBNP, invasive mechanical ventilation, extubation