脓毒血症患儿血浆NT-pro-BNP、PCT的变化及临床意义  

Levels of NT-pro-BNP and PCT in children with sepsis and its clinical significance

作　　者：刘会琼[1] 张敬芳[1] 贾沛生[1] 

机构地区：[1]郑州大学第一附属医院儿科,450000

出　　处：《国际医药卫生导报》2016年第8期1083-1085,共3页International Medicine and Health Guidance News

摘　　要：目的观察脓毒血症患儿血浆氨基末端脑钠肽前体（NT-pro-BNP）和血清降钙素原（PCT）水平的变化及其临床意义。方法选择2012年4月至2014年4月本院儿科重症监护病房的41例脓毒血症患儿作为研究对象，检测其在发病第1天、第3天和转出儿科重症监护病房当天的血浆NT-pro-BNP水平和血清PCT水平，记录当天的急性生理和慢性健康状况-Ⅱ（APACHE-Ⅱ）评分，随访上述患儿的生存状况，并据此将患儿分为存活组29例和死亡组12例。结果发生脓毒血症第1天，两组的APACHE-Ⅱ评分、血浆NT-pro-BNP血清、PCT水平无明显差异（P〉0．05）；发生脓毒血症第3天，死亡组患儿和生存组相比，血浆NT-pro-BNP水平和APACHE-Ⅱ评分均明显增高（P〈0．05），而血清PCT水平无明显差异（P〉0．05）；转出重症监护室当天，死亡组患儿和生存组相比，死亡组患儿的血浆NT-pro-BNP水平、血清PCT和APACHE-II评分均明显增高（P〈0．05）。结论脓毒血症患儿随着病情的进展，血浆NT-pro-BNP水平和血清PCT水平都明显增高，血浆NT-pro-BNP比血清PCT更灵敏反映脓毒血症病情的变化，故根据两者水平的变化可以及早对患儿采取治疗。Objective To observe the changes of the levels of N-terminal pro-brain natriuretic peptide （NT-pro-BNP） and procalcitonin （PCT） in children with sepsis and its clinical significance. Methods 41 children with sepsis admitted into the pediatric ICU at our hospital from April, 2012 to April, 2014 were selected as study objects. Day 1 and 3 of the attack and the day transferred out from ICU, the levels of plasma NT-pro- BNP and serum PCT were detected. The acute physiology and chronic health status-Ⅱ （APACHE-Ⅱ） score was recorded. The children were followed up for their living conditions. And then the patients were divided into a survival group （12 cases） and a death group （29 cases）. Results Day 1 of sepsis attack, there were no statistical differences in APACHE-Ⅱ score and the levels of plasma NT-pro-BNP and serum PCT between these two groups （P〉0.05）. Day 3 of sepsis attack, the level of plasma NT-pro-BNP and APACHE-Ⅱ score were obviously higher in the death group than in the survival group （P〈 0.05）, but there was no statistical difference in serum PCT level between these two groups （P〉0.05）. The day transferred out from ICU, the levels of plasma NT-pro-BNP and serum PCT and APACHE-II score were significantly higher in the death group than in the survival group （P〈0.05）. Conclusions The levels of plasma NT-pro-BNP and serum PCT increase sepsis progress in children. Plasma NT-pro-BNP level is more sensitive in indicating sepsis condition than serum PCT level. Therefore the children with sepsis can be treated early according to the changes of the level of NT-pro-BNP and PCT.

关 键 词：脓毒血症 降钙素原 氨基末端脑钠肽前体 临床意义 

分 类 号：R631[医药卫生—外科学]