| 尿素氮/肌酐对急性肺栓塞预后价值的研究 |
| 投稿时间：2025-06-21 修订日期：2025-07-19 点此下载全文 |
| 引用本文：谭仁香,陈仁山.尿素氮/肌酐对急性肺栓塞预后价值的研究[J].医学研究杂志,2025,54(12):76-81, 105 |
| DOI：
10.11969/j.issn.1673-548X.2025.12.013 |
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| 基金项目:广东省中医药局科研项目(20231252)；花都区基础与应用基础研究区院联合资助项目(24HDQYLH17) |
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| 中文摘要:目的 探讨尿素氮/肌酐(blood urea nitrogen /creatinine ratio,BCR)对急性肺栓塞不良预后的预测价值。方法 本研究是一项回顾性队列研究,研究对象包括MIMIC-Ⅳ(v3.0)数据库中首次入住重症监护室的急性肺栓塞患者。主要研究BCR对入住ICU的急性肺栓塞患者入院后28天全因病死率的预测能力。结果 本研究共纳入1297例患者。根据患者是否在入院28天内发生死亡分为存活组(n=1039)和死亡组(n=258)。COX回归分析结果显示,BCR是入住ICU急性肺栓塞患者28天、60天、90天病死率的独立预测因子。BCR曲线下面积为57.6%,高于单独尿素氮(52.4%)、肌酐(52.4%)、第1天SOFA评分(40.5%)的曲线下面积。根据受试者工作特征曲线,将BCR最佳临界值确定为20.208,使用该临界值绘制的Kaplan-Meier生存曲线提示,BCR≥20.208的患者在入院28天、60天、90天内的全因病死率明显高于BCR < 20.208的患者(P<0.001),限制性立方样条函数提示BCR与急性肺栓塞患者全因病死率呈”U型”非线性关系。亚组分析显示,除充血性心力衰竭、慢性肺病、慢性肾病患者外,BCR的预测价值在各亚组间均稳定(P交互<0.05)。结论 BCR对入住ICU急性肺栓塞患者不良预后具有良好的预测价值。 |
| 中文关键词:急性肺栓塞 尿素氮/肌酐 全因病死率 MIMIC-Ⅳ数据库 |
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| Effect of Blood Urea Nitrogen to Creatinine Ratio on the Prognosis of Patients with Acute Pulmonary Embolism. |
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| Abstract:Objective This study aims to clarify the correlation between blood urea nitrogen to creatinine ratio (BCR) and mortality in acute pulmonary embolism(APE).Methods This retrospective cohort study uses data from the MIMIC-Ⅳ database. The main purpose was to study the predictive ability of BCR on the all-cause mortality of acute pulmonary embolism patients admitted to ICU 28days after admission. Results A total of 1,297 patients are included in this study. The patients are categorized into the survival group (n=1,039) and the death group (n=258) based on survival status within 28days of admission.COX regression analysis shows that BCR is an independent predictor of mortality at 28,60, and 90days.The area under the receiver operating characteristic curve (AUC) for BCR is greater than that for blood urea nitrogen (BUN), creatinine, and the SOFA score. Based on receiver operating characteristic (ROC) curve analysis, a cutoff value of 20.208 is used to construct Kaplan-Meier survival curves. The resulting curves demonstrate that patients in the low-BCR group (BCR < 20.208) have significantly higher survival rates at 28,60, and 90days after admission compared to those in the high-BCR group (BCR ≥ 20.208) (P<0.001). Restricted cubic spline (RCS) analysis suggests a "U-shaped" nonlinear relationship between BCR and all-cause mortality in APE patients. The final subgroup analysis indicates that BCR interacts with congestive heart failure, chronic lung diseases(Pinteraction <0.05). Conclusion BCR can serve as an independent predictor of mortality in APE patients. |
| keywords:Acute pulmonary embolism(APE) Blood urea nitrogen/creatinine ratio(BCR) All-cause mortality MIMIC-Ⅳ database |
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