Correlation Study Between Serum N-terminal Pro-brain Nateiuretic Peptide And Disease Assessment And Prognosis Of Emergency Patients

Objective: To explore relationship between serum N-terminal pro-brain natriuretic peptide(NT-pro BNP)and condition assessment and prognosis of patients in department of emergency.Methods: 208 patients from department of emergency were selected as research objects. Serum level of NT-pro BNP was measured and patients were grouped according to acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) score within the first 24 h after admission. The relationship between serum NT-pro BNP and APACHE Ⅱ score, and their relationships with fatality rate and left ventricular ejection fraction(LVEF) of emergency patients were analyzed.Results: The highest score of NT-proBNP is 23717.4pg/ml,and the lowest is 33.4pg/ml;the median is464.7pg/ml,the average is 1969.0pg/ml.The maximum score of APACHEⅡis 30,and the minimum is 0.The patients are divided into 3 groups according to the score of APACHEⅡless than 15,16~25,more than25,and each group of 81,95 and 32 cases respectively.The three groups are compared by gender,and has no statistical difference(χ2=0.71,P=0.70).The level of serum NP-pro BNP is 141.2pg/ml、531.5pg/ml、more than 3689.0pg/ml in the three groups.There is statistical difference between the score of NT-pro BNP and the group of APACHEⅡ(χ2=68.07,P<0.01),and also has statistical difference between two groups.There are positively correlation between the level of NT-pro BNP with its corresponding APACHE Ⅱ score according to the Spearman rank correlation analysis(rs=0.60,P<0.01). The fatality rate respectively is 0%、2.1%、71.9% in less than 15,16~25,more than 25 group,and there has statistical difference between three groups.Pairwise comparison results:there was no statistically significant difference between the groups of less than 15 scores and 16~25 scores,and both have significant difference compared with more than 25scores(χ2=73.10,P<0.01;χ2=73.70,P<0.01).The serum of NT-pro BNP is 337.1pg/ml in the survival group,and is 4889.8pg/ml in the death group,and there has statistically difference between the two groups(Z=6.50,P<0.01).The average score of APACHEⅡis 11.2±4.8points、23.1±3.1points in the survival and death group respectively,and there has statistically difference between the two groups(t’=﹣16.65,P<0.01).The average serum NT-pro BNP is 330.4pg/ml in the group which the LVEF less than 50%,and the average serum NT-pro BNP is 5022.7pg/ml in the group which the LVEF more than 50%.There has statistically difference between two groups( Z=7.72, P<0.01).TThe average Score of NT-pro BNP respectively is 12.8±6.3points、11.5±4.1points in group which the LVEF less than and more than 50%,and there has no statistical difference between two groups(t’=﹣1.44, P=0.16).Conclusion: Serum NT-proBNP level is positively correlated with patient’s condition and fatality rate,and may be applied to evaluate condition and prognosis of emergency patients.