早期脓毒症患者脑钠肽水平的相关性研究  

Factors influencing BNP level in early sepsis patients

作　　者：李成建[1] 彭月丽[1] 刘静[1] 吴琼[1] 张志伟[1] 徐兰娟[1] 李保林[1] 杨彩浮[1] 

机构地区：[1]郑州大学附属郑州中心医院,河南郑州453000

出　　处：《中国现代医学杂志》2017年第17期88-92,共5页China Journal of Modern Medicine

基　　金：河南省医学科技攻关计划(No:201204136)

摘　　要：目的探讨早期脓毒症患者脑钠肽(BNP)的相关影响因素。方法选取脓毒症患者123例,按照血培养结果分为血培养阳性组和血培养阴性组;按照细菌培养结果分为革兰阴性菌感染组和革兰阳性菌感染组;对实验中两组患者的年龄、白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)、APACHEⅡ评分、左室射血分数(LVEF)、肌酐、乳酸、血小板及BNP进行多元回归分析。结果血培养阳性组的BNP、CRP、WBC、PCT、血小板及乳酸均高于血培养阴性组;革兰阴性菌感染组的APACHEⅡ评分、BNP、乳酸及PCT高于革兰阳性菌感染组;两组患者LEVF比较,差异无统计学意义(P>0.05);多元回归分析提示PCT是BNP的主要影响因素。结论早期脓毒症患者BNP与心功能无关,革兰阴性菌感染患者BNP高于革兰阳性菌感染患者,PCT是导致BNP增加的主要影响因素。Objective To investigate the factors related brain natriuretic peptide （BNP） in patients with early sepsis. Methods Totally 123 patients with sepsis were collected according to the experiment design. The experiment A was designed according to the results of blood culture. The patients with positive boold culture were defined as positive group, and those with negative boold culture were defined as negative group. The experiment B was further designed according to the classification of bacteria. The patients with Gram-negative bacteria infection were taken as Gram-negative group, those with Gram-positive bacteria infection as Gram-positive group. In both experiments, age, white blood cells （WBC）, C-reactive protein （CRP） and procalcitonin （PCT）, APACHE Ⅱ score, left ventricular ejection fraction （LVEF）, creatinine, lactate, platelets and BNP were compared between the two groups of patients. Multivariate regression analysis was used to investigate the influences of age, WBC, CRP, PCT, LVEF, APACHE Ⅱ score, serum creatinine, lactate and platelets on BNP in the experiment A. Results The levels of BNP, CRP, WBC, PCT, platelets and lactic acid of the blood culture positive group were significantly higher than those of the blood culture negative group. The APACHEⅡ score, BNP, lactic acid and PCT of the Gram-negative group were significantly higher than those of the Gram-positive group. There was no statistical difference in LEVF between the two groups in the experiment A or B. Multiple regression analysis suggested that PCT was the major influencing factor of BNP. Conclusions BNP and cardiac function do not have a correlation in early sepsis patients. PCT is the direct factor contributing to the rise of BNP.

关 键 词：脓毒症 脑钠肽 降钙素原 C反应蛋白 脂多糖 

分 类 号：R692[医药卫生—泌尿科学]