脓毒性休克患者血浆脑钠肽与PiCCO相关指标的关系  

The correlation between plasma brain natriuretic peptide(BNP) levels and parameters of pulse-indicated continuous cardiac output(PiCCO) in patients with septic shock

作　　者：吴翔 陶飞 胡桂芳[2] 邓烈华[2] 姚华国[2] 

机构地区：[1]佛山市禅城区中心医院重症医学科,广东佛山528031 [2]广东医学院附属医院重症医学科,广东湛江524001

出　　处：《河南医学研究》2016年第9期1553-1556,共4页Henan Medical Research

摘　　要：目的通过监测脓毒性休克患者血浆脑钠肽(BNP)水平以及脉搏指示连续心排血量(PiCCO)相关指标的变化,探讨脓毒性休克患者脑钠肽水平与心功能的关系。方法选取48例脓毒性休克患者为研究对象,检测患者入ICU第1、3、5天血浆BNP水平,通过PiCCO技术对患者进行血流动力学监测,记录反应心功能指标的CI、CFI、GEF和dP/dPmax,并进行APACHEⅡ、SOFA评分,分析BNP与上述指标的相关性。结果脓毒性休克患者血浆BNP水平与CI、CFI、GE呈负相关(r=-0.339、-0.25、-0.241,P<0.05),与dP/dPmax无显著相关性(P>0.05),与APACHEⅡ评分、SOFA评分呈显著正相关(r=0.509、0.565,P<0.05)。结论 BNP水平不能作为脓毒性休克时考察心功能障碍的指标,但是对病情发展及预后的评估具有一定意义。Objective To investigate the relationship between plasma brain natriuretic peptide （BNP） levels and the monitoring indicators of pulse- indicated continuous cardiac output （PiCCO） in patients with sepstic shock. Methods 48 patients with septic shock according to the criteria of sepsis set by SC- CN/ESICM/ACCP/ATS/SIS were selected. Clinical and laboratory data including BNP were collected on the l d, 3rd and 5th day after admittion. The hemodynamics of the patients was monitored using PiCCO technology, and the heart function indexs were recorded, incluing CI, CFI, GEF and dP/dPmax. Acute Physiology and Chronic Health Evaluation （ APACHE U ） and Sepsis - related Organ Failure Assessment （SOFA） score were determined. The correlation between BNP levels and the above indexs was analyzed. Results The levels of plasma BNP had negative correlation with CI, CFI, GEF （ r = - 0. 339, - 0. 250, - 0. 241, P 〈0. 05 ） , and had no significant correlation with dP/dPmax （ P 〉 0.05 ）. The levels of plasma BNP had significant positive correlation with APACHEII scores and SOFA scores （ r = 0. 509, 0. 565, P 〈 0.05 ）. Conclusion The cardiac function could not be reflected by BNP levels in septic shock patients. Plasma BNP levels can reflect the severity of septic shock in certain degree, and might be considered as a valuable prognostic factor for patients with septic shock.

关 键 词：脓毒性休克 脑钠肽 脉搏指示连续心排血量 

分 类 号：R459.7[医药卫生—急诊医学]