监测血浆B型尿钠肽和肌钙蛋白Ⅰ在脓毒症患者中的意义和预后评估  

Significance and prognosis evaluation of monitoring plasma B-type natriuretic peptide and cardiac troponin I in patients with sepsis

作　　者：丁磊彭 宁安 

机构地区：[1]北京市健宫医院重症医学科,100054

出　　处：《中国综合临床》2017年第10期900-903,共4页Clinical Medicine of China

摘　　要：目的 监测血浆B型尿钠肽（BNP）和肌钙蛋白（cTnI）在脓毒症患者中意义和预后评估.方法 回顾性分析2015年10月至2016年10月我院收治的90例确诊为脓毒症患者的临床资料,按预后分为存活组和死亡组.按心功能分成心功能正常组及心功能不全组,再将心功能不全者分成心功能不全死亡组和心功能不全存活组.分别检测各组患者血浆BNP、cTnI,并使用ROC曲线评估BNP、cTnI对患者预后价值.结果 根据心功能分组发现,心功能不全组中[BNP：6980（5600,9850）ng/L、cTnI：0.82（0.52,1.22）μg/L]显著高于心功能正常组[BNP：2500（1250,5640）ng/L、cTnI：0.52（0.25,0.66） μg/L],两组比较差异均有统计学意义（P均〈0.05）;心功能不全死亡组BNP〔8540（5680,13500）ng/L〕显著高于心功能不全存活组BNP〔5200（3570,8080）ng/L〕,差异有统计学意义（P〈0.05）,而cTnI在心功能不全死亡组和存活组比较差异无统计学意义（P〉0.05）;根据预后结果发现,死亡组患者BNP[7760 （4755,11820）ng/L〕、cTnI〔0.75（0.58,1.46）μg/L〕显著高于存活组[BNP：2058（1200,4711）ng/L、cTnI：0.33（0.22,0.61）μg/L],差异均有统计学意义（P均﹤0.05）.结论 血浆中BNP、cTnI升高可提示患者预后更差;监测血浆中BNP、cTnI有助于脓毒症患者心功能不全早期发现.Objective To evaluate the significance and prognostic evaluation of plasma B-type natriuretic peptide（BNP）and troponin（cTnI）in patients with sepsis.Methods A retrospective analysis was performed on the clinical data of ninety cases of diagnosed septic patients in Beijing Jiangong Hospital from October 2015 to October 2016,the patients were divided into the survival group and the death group.According to the cardiac function,the patients were assigned into the normal heart function group and the heart failure group,and then the cardiac insufficiency patients were divided into the cardiac insufficiency-dead group and cardiac insufficiency-survival group,The plasma levels of BNP and cTnI in each group were detected,and the ROC curve was used to evaluate the influence of BNP,cTnI on patients＇ prognosis.Results According to cardiac function grouping,BNP and cTnI in the cardiac insufficiency group were significantly higher than those in the normal cardiac function group（BNP：6980（5600,9850）ng/L vs.2500（1250,5640）ng/L〕; cTnI： 0.82 （0.52,1.22）μg/L）vs.0.52（0.25,0.66）μg/L）,the differences were statistically significant（P〈0.05）;BNP in the cardiac insufficiency-dead group（8540（5680,13500）ng/L）was significantly higher than that in the cardiac insufficiency-survival group（5200（3570,8080）ng/L）,the difference was statistically significant （P〈0.05）; There was no significant difference in cTnI between the cardiac insufficiency-dead group and the cardiac insufficiency-survival group（P〉0.05）;According to the prognosis,BNP and cTnI in the cardiac insufficiency-dead group were all significantly higher than those in the cardiac insufficiency-survival group〔BNP：7760（4755,11820）ng/L vs.2058（1200,4711）ng/L; cTnI：〔0.75（0.58,1.46）μg/L〕 vs.0.33（0.22, 0.61）μg/L〕,the differences were statistically significant（P〈0.05）.Conclusion The increase of BNP and cTnI in plasma may indicate a worse prognosis for patients.The monitoring of BNP and c

关 键 词：脓毒症 B型尿钠肽 肌钙蛋白Ⅰ心功能不全 

分 类 号：R541.4[医药卫生—心血管疾病]