氨基末端B型钠尿肽前体及肌钙蛋白I对脓毒症预后的预测价值  

Predictive value of N-terminal pro-brain natriuretic peptide and cardiac troponin I for prognosis of sepsis

作　　者：雷艳[1] 罗玉珍[1] 赵英萍[1] 张辉[1] 李超梁[1] 汪海芹[1] 

机构地区：[1]中山大学附属江门巿中心医院重症医学科,江门529030

出　　处：《中国当代医药》2014年第14期17-19,23,共4页China Modern Medicine

基　　金：广东省江门市第一批科技计划项目(江科[2012]107号第57项)

摘　　要：目的评价氨基末端B型钠尿肽前体(NT-pro-BNP)及肌钙蛋白I(cTnI)对脓毒症预后判断的作用。方法入选住院的脓毒症患者66例,按病情严重程度,分为一般脓毒症组(24例)、严重脓毒症组(22例)及脓毒症休克组(20例);根据患者的28天生存率,分为死亡组(20例)和存活组(46例)。在入院24小时内检测血清cTnI、NT-pro-BNP及降钙素原(PCT)水平,并进行急性生理和慢性健康状况评分Ⅱ(APACHEⅡ评分),比较各组血清cTnI、NT-pro-BNP、PCT水平及APACHEⅡ评分,分析NT-pro-BNP、cTnI水平与PCT水平、APACHEⅡ评分的相关性。结果脓毒症休克组的血清NT-pro-BNP、cTnI、PCT水平及APACHEⅡ评分明显高于严重脓毒症组及一般脓毒症组,差异具有统计学意义(P<0.05)。严重脓毒症组的血清NT-pro-BNP、cTnI、PCT水平及APACHEⅡ评分高于一般脓毒症组,差异具有统计学意义(P<0.05)。死亡组的血清cTnI、NT-pro-BNP、PCT水平及APACHEⅡ评分明显高于生存组(P<0.05)。血清NT-pro-BNP、cTnI水平与PCT呈正相关(r分别=0.901,0.866,P<0.05),血清NT-pro-BNP、cTnI水平与APACHEⅡ评分呈正相关(r=0.602、0.521,P<0.05)。结论血清cTnI与NT-pro-BNP联合检测可以作为常规临床检测指标来判断脓毒症患者的预后。Objective To evaluate the role of N-terminal pro-brain natriuretic peptide （NT-pro-BNP） and cardiac tro- pouin I for prognosis of sepsis. Methods 66 patients with sepsis admitted into our hospital were divided into the gener- al sepsis group （n=24）,the severe sepsis group （n=22） and the sepsis shock group （n=20） according to patients＇ condi- tion.Meanwhile the patients were divided into the survival group （n=46） and the death group （n=20）.according to 28 days＇survival rate of patients. The serum NT-pro-BNP,cTnI and PCT level were measured and APACHE R score were conducted when the patients stayed in ICU in 24 hours.The serum NT-pro-BNP, cTnI and PCT level and the APACHE R score among three groups were compared. The correlation of NT-pro-BNP,cTnI and PCT,APACHE lI score were analyzed. Results The serum NT-pro-BNP,cTnI and PCT level and the APACHE H score in the sepsis shock group were significantly higher than those in the general sepsis group and severe sepsis group （P〈0.05）.The serum NT-pro- BNP,eTnI and PCT level and the APACHE Ⅱ score in the severe sepsis group were significantly higher than those in the sepsis group （P〈0.05）.The NT-pro-BNP,cTnI and PCT level and the APACHE Ⅱ score of the death group were significantly higher than those of the survival group （P〈0.05）.The serum NT-pro-BNP,cTnI and PCT level were positive related respectively （r=0.901,0.866,P〈0.05）;The serum NT-pro-BNP, cTnI level and APACHE Ⅱ score were positive related respectively （r=0.602,0.521,P〈0.05）. Conclusion Detection of NT-pro-BNF Combined with cTnI level could be a routine clinical detection index to evaluate prognosis of patients with sepsis.

关 键 词：脓毒症 氨基末端B型钠尿肽前体 肌钙蛋白I 降钙素原 APACHEⅡ评分 预后 

分 类 号：R714.251[医药卫生—妇产科学]