脓毒症患者血浆脑钠肽水平的变化及与预后的相关性分析  

Clinical study on the relationship between the changes of plasma level of brain natriuretic peptide and prognosis of patients with sepsis

作　　者：赵鸿雁[1] 丛树国[1] 王丽丽[1] 孙翠梅[1] 

机构地区：[1]大庆油田总医院,大庆163001

出　　处：《内科急危重症杂志》2013年第1期18-20,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨血浆脑钠肽(BNP)水平变化对脓毒症患者治疗的指导价值及其对预后的影响。方法:102例脓毒症患者分为脓毒症组35例,严重脓毒症组37例,脓毒性休克组30例,并选择同期健康体检者40例。同时根据患者2周内的存活情况分为存活组和死亡组。分析3组患者血浆BNP水平、左室射血分数(LVEF)及APACHEⅡ评分的变化。结果:脓毒症患者入院后第1天和第3天血浆BNP水平较对照组明显升高,且随着病情的加重,患者血浆BNP水平依次增加(P<0.05)。脓毒症组入院第1天和第3天BNP与APACHEⅡ评分无相关性(P>0.05),而严重脓毒症和脓毒性休克组BNP与APACHEⅡ评分均呈正相关(均P<0.05)。与存活组比较,死亡组入院第1天和第3天血浆BNP水平显著升高,LVEF明显降低(均P<0.05),2者均是脓毒症患者死亡的独立危险因素(OR=1.043、1.167,均P<0.05)。结论:脓毒症患者血浆BNP水平显著升高,BNP水平的检测可以作为脓毒症患者的病情严重程度以及预后的评价指标。Objective： To explore the guidance value of the changes of plasma level of brain natriuretic peptide （BNP） during treatment of patients with sepsis and its effect on prognosis. Methods： One hundred and two cases with sepsis were divided into sepsis group （35 cases）, severe sepsis group （37 cases） and septic shock group （30 cases）, 40 healthy per- sons were selected as the control group. All the patients were also divided into survivor and death group according to wheth- er they survived within 2 weeks. Plasma level of BNP, left ventricular ejection fraction （LVEF） and APACHE II score were compared. Results ： Plasma level of BNP on I st and 3rd day after admission in the three sepsis groups were signifi- cantly higher than that in the control group, and with the progression of the severity of the disease, plasma level of BNP was increased （P 〈 0.05 ）. There was no significant relation between plasma level of BNP and APACHE II score on 1 st and 3rd day after admission in sepsis group （ P 〉 0.05 ）, while positive relation was found in both severe sepsis and septic shock group （ P 〈 0.05 ）. Compared with those of survivor group, plasma level of BNP on I st and 3rd day after admission in death groups increased, and LVEF decreased significantly （ P 〈 0.05 ）. By Logistic regression analysis, increased plasma level of BNP and decreased LVEF were all independent predictors of mortality of sepsis. Conclusions： Plasma level of BNP in- creased significantly in patients with sepsis, and it can be used as an indicator for severity of the disease and prognosis in patients with sepsis.

关 键 词：脓毒症 脑钠肽 左室射血分数 预后 

分 类 号：R515.3[医药卫生—内科学]