脓毒症患者血清N端B型钠尿肽原水平与预后的相关性  

Clinical Study on the Correlation between the Changes of Plasma Level of NT-proBNP and Prognosis of Patients with Sepsis

作　　者：陈伟峰[1] 幸泽茂[1] 张宪华[1] 周丹[1] 郑晓英[1] 

机构地区：[1]深圳市第二人民医院急诊ICU,广东深圳518000

出　　处：《医学综述》2014年第11期2058-2059,共2页Medical Recapitulate

摘　　要：目的探究并分析血清N端B型钠尿肽原(NT-proBNP)水平对脓毒症患者病情与预后的相关性。方法选取深圳市第二人民医院2010年1月至2012年1月收治的150例患者为研究对象,根据治疗后的预后状况分为生存组(125例)和死亡组(25例),比较两组患者血清NT-proBNP、急性生理和慢性健康状况(APACHEⅡ)评分、血乳酸及左心室射血分数(LVEF);根据脓毒症程度分为脓毒症组(55例)、严重脓毒症组(60例)、脓毒症休克组(35例),分析观察三组患者血清NT-proBNP水平及APACHEⅡ评分、血乳酸及LVEF的变化。结果存活组和死亡组患者血清NT-proBNP、血乳酸及APACHEⅡ评分和LVEF的比较,差异均有统计学意义(P<0.05);脓毒症休克组患者与严重脓毒症、轻度脓毒症组的血清NT-proBNP水平差异有统计学意义(P<0.05);血清NT-proBNP与APACHEⅡ评分存在直线相关关系。随着患者的病情加重,血清NT-proBNP、血乳酸水平及APACHEⅡ评分分别依次升高,而LVEF却降低,比较差异均有统计学意义(P<0.05)。结论脓毒症患者血清NT-proBNP水平明显增高,随着病情的增加,其呈线性增长趋势。血清NT-proBNP水平变化有助于评估脓毒症患者病情以及预后的判断,值得临床推广使用。Objective To explore the guidance value of the changes of plasma level of NT-proBNP during treatment of patients with sepsis and its effect on prognosis. Methods A total of 150 patients with sepsis in Shenzhen Second People＇s Hospital from Jan. 2010 to Jan. 2012 were studied. According to prognosis after treatment, the patients were divided into survival group （ 125 cases） and death group （25 cases）. The serum NT-proBNP, Acute Physiology and Chronic Health Evaluation（ APACHE Ⅱ score）, blood lactate, and left ventricular ejection fraction （LVEF） of the two groups were compared. According to the degree of sepsis, they were divided into sepsis group （ 55 cases）, severe sepsis group （ 60 cases ）, septic shock group （ 35 cases）, the serum NT-proBNP levels, APACHE Ⅱ score, blood lactate, and left ventricular ejection fraction （LVEF） changes of the three groups were observed and analyzed. Results NT-proBNP, blood lactate, APACHE II score and LVEF of the survival group and death group were statistically significantly different （P 〈0.05 ） ; the differences of serum NT-proBNP levels between septic shock group and sepsis group and severe sepsis group were statistically significant （ P 〈 0.05 ） ; the serum NT-proBNP and APACHE Ⅱ score has linear correlation. With the aggravation of the disease, the serum NT-proBNP levels, lactate levels and APACHE Ⅱ score subsequently increased,while LVEF decreased,the difference was statistically significant （P 〈 0.05 ）. Conclusion Serum NT-proBNP levels of patients with sepsis are significantly increased, increasing linearly with the aggravation of the disease, and it is helpful for the assessment of the severity and prognosis of sepsis, thus is worth of promotion in clinical.

关 键 词：脓毒症 血清N端B型钠尿肽原 预后 相关性 

分 类 号：R55[医药卫生—血液循环系统疾病]