脑钠肽水平对感染性休克患者心功能的评估研究  

Value of brain natriuretic peptide level in evaluation of heart function of patients with septic shock

作　　者：赵映[1] 刘苏[1] 刘淑芳[2] 

机构地区：[1]海南医学院附属医院心脏外科,海南海口570000 [2]海南医学院附属医院特需病区,海南海口570000

出　　处：《中华医院感染学杂志》2015年第13期2891-2893,共3页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(809042)

摘　　要：目的探讨分析氨基末端脑钠肽前体(NT-proBNP)水平对感染性休克患者心功能的评估价值,为临床感染性休克患者的心功能评价提供有效地科学参考依据。方法选取2011年3日-2014年2月47例感染性休克患者被分为死亡组与存活组,并在患者进入ICU后根据心功能的动态变化将其分为心功能正常组与心功能不全组,比较两组患者的临床资料及进入ICU后不同时间点NT-proBNP的水平与患者心功能的相关性。结果进入ICU第1、2、3天,存活组患者血浆NT-proBNP的水平明显低于死亡组患者,差异有统计学意义(t=28.242、26.058、30.287,P<0.01);NT-proBNP水平在第1天与患者的体质指数呈负相关(P<0.05),在第3天与患者的体质量指数、左室多普勒E/A值呈负相关(P<0.05),在第7天与左室多普勒E/A值、左室射血分数、组织多普勒成像下二尖瓣口血流频谱收缩期峰值、组织多普勒成像下二尖瓣环侧壁峰值运动速度e/a比率呈负相关(P<0.05),而与左心Tei指数呈正相关(P<0.05);入住ICU第7天,心功能正常组脑钠肽(BNP)的水平要明显低于心功能不正常组(t=6.542 P<0.01)。结论感染性休克患者发病1周后,其血浆脑钠肽对于左心室功能受损有着一定的提示作用,但在临床中应结合其他检查依据。OBJECTIVE To explore the value of the level of N‐terminal pro‐brain natriuretic peptide （NT‐proBNP） in evaluation of heart function of the patents with septic shock so as to provide scientific basis for evaluation of the heart function of the patients with septic shock .METHODS A total of 47 patients with septic shock who were trea‐ted from Mar 2011 were enrolled in the study and divided into the death group and the survival group ,and the in‐cluded patients were divided into the normal heart function group and the cardiac dysfunction group according to the dynamic change of heart function after admission to the hospital .The clinical data were compared between the two groups of patients ,and the relationship between the levels of NT‐proBNP at the time points after the admis‐sion to the hospital and the heart function was observed .RESULTS The levels of plasma NT‐proBNP of the surviv‐al group were significantly lower than those of the death group on day 1 ,2 ,and 3 after the admission to the hospi‐tal （t=28 .242 ,26 .058 ,30 .287 ,P〈0 .01 ）;the level of NT‐proBNP on day 1 was negatively correlated with the body mass index （P〈0 .05）;the level of NT‐proBNP on day 3 was negatively correlated with the body mass index and left ventricle‐Doppler E/A value;the level of NT‐proBNP on day 7 was negatively correlated with the left ven‐tricular Doppler E/A value ,left ventricular ejection fraction ,systolic mitral inflow peak under tissue Doppler ima‐ging ,and mitral annular sidewall peak velocity e/a ratio under tissue Doppler imaging （P〈 0 .05） ,however ,it was positively correlated with the left ventricular Tei （P〈0 .05） .The level of brain natriuretic peptide （BNP） of the normal heart function group was significantly lower than that of the cardiac dysfunction group （t=6 .542 ,P〈0 .01） .CONCLUSION The level of plasma BNP plays certin role in reminding the damage of the left ventricular function after the onset of septic shock for one week ,but it should

关 键 词：血浆脑钠肽 感染性休克 心功能 

分 类 号：R446[医药卫生—诊断学]