大脑天然尿素作为败血症死亡率的预测标志物:更新的系统性审查和元分析
Jian-Li Song1, Bin Fan1, Li-Quan Qiu1
1Departments of Anesthesiology, Zigong Fourth People's Hospital, Zigong, Sichuan, People's Republic of China.
BMC anesthesiology
|August 7, 2024
概括
大脑天然尿素 (BNP) 和N-终端亲B型天然尿素 (NT-proBNP) 对败血症死亡率具有中等预后价值. 布朗尼显示出更高的灵敏度和特异性,并确定了最佳的切断范围,以改善患者的风险评估.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 生物标志物研究 生物标志物研究
背景情况:
- 早期识别高风险败血症患者至关重要,但具有挑战性.
- 大脑天然尿素 (BNP) 和N-终端亲B型天然尿素 (NT-proBNP) 在败血症的预后价值是有争议的.
研究的目的:
- 为了澄清BNP和NT-proBNP在败血症患者的预后价值.
- 为这些生物标志物建立合适的切断值和间隔.
主要方法:
- 进行了对47项研究的元分析.
- 关键结果包括聚合的灵敏度,特异性,概率比率和曲线下的面积 (AUC).
- 进行了子组分析,以确定最佳切断范围.
主要成果:
- 与NT-proBNP (分别为0.77和0.70) 相比,BNP表现出更高的聚合灵敏度 (0.82) 和特异性 (0.77).
- 对于BNP (0.87),曲线下的面积 (AUC) 大于NT-proBNP (0.80).
- 400-800 pg/mL的BNP切线范围显示出高灵敏度 (0.86) 和特异性 (0.87).
结论:
- 较高的BNP和NT-proBNP水平与败血症死亡率有显著的关联.
- 这些生物标志物对于预测败血症死亡率具有中等的预后价值.
- 确定了BNP和NT-proBNP的初步适当的切割值.
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