血NT-BNP在脓毒症中的应用价值  

Clinical Value of Serum NT-BNP in Sepsis

作　　者：易玲娴[1] 张长春[1] 易勇[2] 贾晓君[1] 张淑敏[1] 高洁[1] 王嵩[1] 

机构地区：[1]中国人民解放军第306医院ICU,北京100101 [2]中国人民解放军第306医院检验科,北京100101

出　　处：《医学研究杂志》2016年第5期91-93,共3页Journal of Medical Research

基　　金：全军"十二五"课题(面上项目)(CWS11J174)

摘　　要：目的评估NT—BNP在脓毒症诊断及预后中的作用。方法选取2014年1月1日～12月30日收入笔者医院ICU病房的脓毒症患者65例，脓毒症休克患者39例，以及正常健康人24例作为对照组。人院后1h内抽取动脉血检测LAC水平，24h内进行APACHE2评分，入院第1、3、5天抽取静脉血检测炎性指标WBC、CRP、PCT及NT—BNP的水平。脓毒症及脓毒症休克患者按（2014年国际严重脓毒症和脓毒症休克治疗指南》进行治疗。结果①脓毒症组和脓毒症休克组在第1、3、5天CRP、PCT、NT—BNP水平较对照组升高，且脓毒症休克组较脓毒症组升高。脓毒症组及脓毒症休克组LAC水平、APACHE2评分及病死率均高于对照组，并且脓毒症休克组高于脓毒症组。入院时脓毒症组与脓毒症休克组NT—BNP与PCT、LAC以及A—PACHE2评分呈正相关。结论脓毒症患者早期NT—BNP可显著升高，并与临床疗效及患者预后有关。因此，NT—BNP在脓毒症患者早期诊断及预后评估中具有重要价值。Objective To evaluate the function of NT - BNP in sepsis diagnosis and prognosis. Methods ICU patients from 1st, January to 30^th, December in 2014 were analyzed, including sepsis patients（ n = 65） and septic shocks （ n = 39）. Control group induded 24 health people. After admission, the level of LAC was examined in the first hour and APACHE2 score was analyzed in the first 24 hours. The levels of WBC, CRP, PCT and NT - BNP were determined at day 1, 3, 5. Sepsis and septic shock patients were treated accroding to the international guidance for treating serious sepsis and septic shock in 2014. Results The levels of CRP, PCT and NT - BNP on the day 1,3,5 were increased significantly in sepsis group and septic shock group compared with those in control. Compared with sepsis group, there was a remarkable increase in the level of these inflammatory indices in septic shock group. The lever of LAC and APACHE2 score in sepsis and septic shock group were higher when compared with control group, and those in septic shock group were higher than sepsis group. There was a positive relationship between NT - BNP and PCT, LAC and APACHE2 score in the sepsis and septic shock group. Conclusion NT -BNP was significantly higher in sepsis patients and largely related with disease therapy and prognosis. Therefore, Serum NT - BNP plays a critical role in the early diagnosis and assessing the prognosis for septic patients.

关 键 词：降钙素原 脑钠肽 乳酸 脓毒症 

分 类 号：R446.11[医药卫生—诊断学]