血清氨基末端脑钠肽前体/胆碱酯酶比值评估脓毒症患者的临床研究  

Clinical study on the application of ratio of serum N-terminal pro-brain natriuretic peptide and ChE in patients with sepsis

作　　者：牛芳[1] 宋熔[1] 杨靖[1] 马建华[1] 陈侃侃[1] NIU Fang SONG Rong YANG Jing MA Jianhua CHEN Kangkang(Intensive Care Unit,the Fifth Hospital of Chinese PLA ,Yinchuan , Ningxia 750004,Chin)

机构地区：[1]中国人民解放军第五医院重症医学科,银川750004

出　　处：《检验医学与临床》2016年第19期2709-2710,2713,共3页Laboratory Medicine and Clinic

基　　金：银川市科技局科技发展项目(YCKJ-2013-57)

摘　　要：目的探讨血清氨基末端脑钠肽前体(NT-proBNP)/胆碱酯酶(ChE)水平比值在评估脓毒症患者病情及预后的临床价值。方法 107例ICU脓毒症患者24h内进行急性生理学及慢性健康状况评分系统(APACHEⅡ)评分,同时检测血清NTproBNP及ChE水平,按患者病情分为轻度脓毒症组(C组),严重脓毒性及脓毒性休克组(S组),分析NT-proBNP、ChE、NTproBNP/ChE、APACHEⅡ评分与患者预后关系。结果 S组中死亡和存活患者ChE、NT-proBNP/ChE、APACHEⅡ评分比较,差异有统计学意义(P<0.05),而C组中差异无统计学意义(P>0.05);S组中APACHEⅡ评分、ChE、NT-proBNP/ChE与预后有显著相关(P<0.05),NT-proBNP与预后无相关(P>0.05)。C组中NT-proBNP、ChE、NT-proBNP/ChE、APACHEⅡ评分与预后均无相关(P>0.05)。结论 NT-proBNP/ChE比值可作为严重脓毒症及脓毒性休克患者病情及预后的预测因素,具有一定的临床应用价值。Objective To investigate the clinical value of ratio of serum N-terminal pro-brain natriuretic peptide（NT-proBNP）and acetylcholinesterase（ChE）in evaluating the severity and prognosis of patients with sepsis.Methods A total of 107 ICU patients with sepsis within 24 hours were evaluated by acute physiology and chronic health evaluationⅡ（APACHEⅡ）,at the same time serum concentrations of NT-proBNPand ChE were detected,according to the patient′s condition,107 patients were divided into mild sepsis group（group C）,severe and shock sepsis group（group S）,the correlations of NT-proBNP,ChE,NT-proBNP/ChE,APACHEⅡ score and prognosis in patients were analyzed.Results The ChE,NT proBNP/ChE,APACHEⅡ score between death and survival patients in group S had significant differences（P〈0.05）,but there were no significant differences in group C（P〉0.05）.Binary logistic regression analysis showed APACHEⅡ score,ChE,NT-proBNP/ChE in group S had correlation with prognosis of patients（P〈0.05）,and NT-proBNPin group S had no correlation with prognosis of patients（P〉0.05）.The indexes and prognosis in group C showed no correlation（P〉0.05）.Conclusion NT-proBNP/ChE score has a certain application value for assessing the severity and prognosis of patients with severe sepsis.It could be used as a predictor for clinical treatment and provide some guidance.

关 键 词：脓毒症 氨基末端脑钠肽前体 胆碱酯酶 

分 类 号：R541.61[医药卫生—心血管疾病]