老年脓毒症患者血浆BNP和肌钙蛋白I检测的临床价值  

Clinical value of tests of plasma BNP and troponin I for elderly patients with sepsis

作　　者：张志荣[1] 李强[2] 

机构地区：[1]浙江中医药大学附属第一医院重症医学科,浙江杭州310053 [2]浙江大学医学院附属第二医院脑重症医学科,浙江杭州330100

出　　处：《中国现代医生》2015年第19期19-21,25,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2013RCA023)

摘　　要：目的探究老年脓毒症患者血浆B型脑钠肽（BNP）和肌钙蛋白I（Tn I）检测的临床价值。方法选取2011年1月~2014年1月我科接收治疗的108例老年脓毒症患者,根据病情严重程度分为三组,其中一般脓毒症64例（A组）,严重脓毒症32例（B组）,脓毒症休克12例（C组）。所有患者入科后立即检测其血浆BNP和Tn I的质量浓度。采用超声心动图检查测定患者的LVEF值,并进行APACHEⅡ评分。对B组、C组患者28 d的生存情况进行随访,对比存活患者和死亡患者的各项指标情况及BNP、Tn I与APACHEⅡ评分之间的关系。结果 A组患者的Tn I和BNP分别为（0.08±0.01）μg/L和（206.42±76.15）pg/m L,B组分别为（0.53±0.01）μg/L和（386.38±84.96）pg/m L,C组分别为（1.94±0.04）μg/L和（958.84±135.23）pg/m L,三组患者血浆BNP、Tn I质量浓度比较差异均具有统计学意义（P〈0.05）。患者病情越重,血浆BNP、Tn I质量浓度越高。存活组患者的Tn I和BNP分别为（0.47±0.08）μg/L和（692.59±22.17）pg/m L,APACHEⅡ为（19.5±5.2）分,LVEF为（52.1±13.9）%。死亡组分别为（1.23±0.05）μg/L、（986.25±22.65）pg/m L、（23.1±6.1）分、（41.5±11.5）%。死亡患者的BNP、Tn I和APACHEⅡ评分显著高于存活组,死亡组的LVEF显著低于存活组,差异均具有统计学意义（P〈0.05）。结论血浆BNP和Tn I的质量浓度可作为老年脓毒症患者病情评估和预后判断的有效指标。Objective To explore the clinical value of tests of plasma type B natriuretic peptide （BNP） and troponin I （TnI） for elderly patients with sepsis. Methods A total of 108 elderly patients with sepsis who were admitted and treated in our department from January 2011 to January 2014 were selected. They were assigned to three groups according to the disease severity, 64 patients with common sepsis were as group A, 32 patients with severe sepsis were as group B, and 12 patients with septic shock were as group C. After being admitted to our department, mass concentration of plas-ma BNP and TnI for all patients were tested immediately. LVEF value of patients was tested by ultrasonic cardiogram, and APACHE II score was calculated. 28-day survival conditions for patients in group B and group C were followed up, each index between surviving patients and dead patients and connections between scores of BNP, TnI and APACHEIIwere compared. Results TnI and BNP for patients in group A were （0.08±0.01）μg/L and （206.42±76.15） pg/mL re spectively, in group B were （0.53±0.01） μg/L and （386.38±84.96） pg/mL respectively, in group C were （1.94±0.04） μg/L and （958.84±135.23） pg/mL respectively. The differences of mass concentrations of plasma BNP and TnI among the three groups were statistically significant （P〈0.05）. The more severe the disease conditions, the higher the mass con-centrations of plasma BNP and TnI. TnI and BNP for patients in the survival group were （0.47±0.08） μg/L and （692.59±22.17） pg/mL respectively, APACHEII was scored as （19.5±5.2）, and LVEF was （52.1±13.9）%, while in the dead group were （1.23±0.05） μg/L, （986.25±22.65） pg/mL, （23.1±6.1） Scores, （41.5±11.5）%. The scores of BNP, TnI and APACHEII in dead group were significantly higher than those in the surviving group, and LVEF in dead patients was significantly lower than that in the survival group, the differences were statistically significant （P〈0.05）. Conclusion Mass

关 键 词：老年 脓毒症 B型脑钠肽 肌钙蛋白I 

分 类 号：R459.7[医药卫生—急诊医学]