脓毒症患者血浆脑钠肽水平检测及其临床意义  

The Expression of Brain Natriuretic Peptide in Patients with Sepsis and Its Clinical Significance

作　　者：陈文元[1] 吴智鑫[1] 张英俭[1] 高振和[1] 刘绍辉[1] 冯景昉[1] 陈景利[1] 

机构地区：[1]广东省佛山市中医院急诊科,广东佛山528000

出　　处：《中国血液流变学杂志》2013年第2期281-283,共3页Chinese Journal of Hemorheology

摘　　要：目的检测脓毒症患者血液中腩钠肽表达的变化，探讨其相关的临床意义。方法收集2011年12月～2012年12月急诊ICU收治的脓毒症患者74例，另取同期健康体检者40名作为正常对照。74例脓毒症患者分为轻度组（APACHEⅡ≤10，n=22）、中度组（11〈APACHEⅡ〈20，n=32）和重度组（APACHEⅡ≥21，n=20）。脑钠肽表达的测定使用ELISA法。结果脓毒症患者脑钠肽的表达水平显著高于健康对照组（｜P〈0．01）。轻度组、中度组和重度组脓毒症患者脑钠肽的表达水平之间具有显著性差异（P〈0．05）；其中重度组显著高于中度组（P〈0．05），中度组又显著高于轻度组（P〈0．01）。第1、3、7天时恶化组脑钠肽的表达水平均显著高于好转组（P〈0．01），随着时间的推移好转组脑钠肽的表达水平逐渐降低（P〈0．05），而恶化组脑钠肽的表达水平则逐渐升高（P〈0．05）。结论脑钠肽表达的升高可能参与了脓毒症病变的发生、发展过程，脑钠肽的榆测有可能成为脓毒症患者的早期诊断以及预后评估指标。Objective To investigate the expression and clinical significance of brain natriuretic peptide（BNP） in patients with sepsis.Methods A total of 74 cases of patients with sepsis were enrolled in our study.Another 40 healthy people were used as a normal control.Patients were devided into three groups：light group（APACHE ]I ~ 10,n=22）,middle group（ll 〈 APACHE II 〈 20,n=32）,and heavy group（APACHE II ~〉21,n=20）.The expression of BNP was detected by ELISA analysis.Results The expression of BNP in sepsis group was 171.2 ＋ 26. lpg/mL,and which was higher than that of 37.5 ＋ 7.4pg/mL in control group（P 〈 0.01）.The expression of BNP in light group,middle group,and heavy group was 82.4 ＋ 13.2pg/ mL,156.5 ＋ 24.7pg/mL,and 281.2 ＋ 34.6pg/mL.There was significant difference among the three groups（P 〈 0.05）,which was higher in heavy group than that in middle group（P 〈 0.05）,and middle group than that in light group（P 〈 0.01）.The expression of BNP in improve group was 146.2 ＋ 25.8pg/mL,118.6 ＋ 22.1pg/ mL,and 90.5 _ 11.4pg/mL at 1,3,7 day.The expression of BNP in deterioration group was 288.6 ＋ 35.3pg/ mL,326.3 _ 43.4pg/mL,and 386.4 ＋ 52.6pg/mL at 1,3,7 day.The BNP expression was higher in deterioration group than that in improved group at 1,3,7 day（P〈 0.01）.The expression of BNP in improved group was decreased,according to time reducing（P 〈 0.05）.The expression of BNP in deterioration group was increased, according to time reducing（P 〈 0.05）.Conclusion The overexpression of BNP may be involved in the occurrence and development of sepsis,which might be used as a mark to estimate the degree of differentiation or prognosis of sepsis.

关 键 词：脓毒症 脑钠肽 预后 

分 类 号：R459.7[医药卫生—急诊医学]