脓毒症休克与血清氨基末端B型利钠肽前体研究进展  

Research Progress on N-terminal Pro-brain Natriuretic Peptide in Septic Shock

作　　者：商娜 张源波 周荣斌 杨萌 

机构地区：[1]北京市军区总医院急诊科,100700

出　　处：《中国全科医学》2013年第9期1030-1032,共3页Chinese General Practice

基　　金：首都医学发展科研基金(2009-1026)

摘　　要：脓毒症休克是极为常见的危重病,病情凶险,病死率高达30%～70%。近年来,随着早期目标指导性治疗(EGDT)在重症领域的应用,其病死率有了很大改善。目前,临床医师多数根据血流动力学指标的异常指导治疗和判断预后,但血流动力学指标的获得操作复杂、技术要求高,且具有一定的滞后性。国内外学者一直致力于探索敏感性和特异性较高的生物标记物——血清氨基末端B型利钠肽前体(NT-proBNP),希望为脓毒症休克的早期积极干预提供参考依据。研究发现,脓毒症休克时NT-proBNP升高有多种机制参与,NT-proBNP水平的变化可指导脓毒症休克患者的治疗和判断预后。NT-proBNP检测简便迅速,具有广阔的临床应用前景。本文主要结合国内外文献探讨脓毒症休克时NT-proBNP变化机制及其临床应用。Septic shock is a very common disease and its mortality rate is as high as 30% to 70%. In recent years, with the widely application of early goal - directed therapy （EGDT） in intensive illnesses, the mortality rate was greatly reduced. Currently, hemodynamic parameters are used to guide treatment and predict prognosis, but these parameters can only be obtained by skilled operators and are time - consuming. Domestic and foreign scholars have been dedicated to exploring a biological marker with high sensitivity and specificity, that is, serum amino - terminal pro - brain natriuretic peptide （ NT - proBNP）, which can provide reference for the early intervention and prediction of patients with septic shock. Studies have found that multiple mechanisms can cause the changes of NT - proBNP level in septic shock, and these changes can guide treatment and prognosis of patients with septic shock. Besides, the detection of NT - proBNP is simple and fast, so its chnical apphcation is promising. This paper is aimed to introduce mechanisms of NT - proBNP change in septic shock and its clinical application.

关 键 词：氨基末端B型利钠肽前体 休克 脓毒性 预测 

分 类 号：R631.4[医药卫生—外科学]