BNP检测在脓毒症性心功能不全中的临床价值  

The clinical value of BNP in sepsis cardiac insufficiency

作　　者：杨博[1] 谭家余[1] 杨亚东[1] 林仰东[1] 吴志雄[1] 黄丽萍[1] Yang Bo;Tan Jiayu;Yang Yadong(The Bocd Hospital of Zhongs han City,Zhongshan,Guangdong 528400)

机构地区：[1]中山市博爱医院,广东中山528400

出　　处：《基层医学论坛》2021年第1期19-21,共3页The Medical Forum

基　　金：中山市卫生局科研项目(2017A020054)。

摘　　要：目的探讨脑钠肽(BNP)检测在脓毒症性心功能不全中的临床价值。方法选取2017年3月-2020年5月收治的脓毒症性休克患者75例,入院检测患者BNP水平,同时记录患者APACHEⅡ评分、肿瘤坏死因子α、白细胞介素-6。另对患者行心脏超声检查,记录患者左室射血分数(LVEF)和存活情况,进行对比分析。结果 LVEF>40%组患者的入院时血浆BNP水平和APACHEⅡ分值均低于LVEF≤40%组患者,且TNF-α和IL-6水平亦更低,差异具有显著统计学意义(P<0.01)。存活组患者的入院时血浆BNP水平和APACHEⅡ分值均低于死亡组患者,且TNF-α和IL-6水平亦更低,差异具有显著统计学意义(P<0.01)。经Pearson法检验,入院第1天,BNP与APACHEⅡ评分呈显著正相关(r=0.44,P<0.01),BNP与TNF-α呈显著正相关(r=0.53,P<0.01),BNP与IL-6呈显著正相关(r=0.48,P<0.01)。结论脓毒症患者早期BNP水平即可有明显升高,而伴有心功能不全的脓毒症患者,其早期BNP水平升高更加明显。早期较高的BNP水平往往预示着较低的LVEF水平、较高的TNF-α和IL-6水平以及较差的预后,针对此类患者应加以重视,及时干预。Objective To explore the clinical value of brain natriuretic peptide(BNP) in sepsis induced cardiac insufficiency.Methods From March 2017 to May 2020,75 patients with sepsis shock were selected.BNP levels of patients were measured and APACHE Ⅱ scores,TNF-α,IL-6 were recorded.The left ventricular ejection fraction(LVEF) and survival of the patients were recorded by echocardiography and analyzed by statistical method.Results The BNP level and APACHE Ⅱ score of patients with LVEF>40% were lower than those of patients with LVEF ≤40%,The levels of TNF-α and IL-6 were also lower,the difference was statistically significant(P<0.01).The BNP level and APACHE Ⅱ score of the patients in the survival group were significantly lower than those in the death group,The levels of TNF-α and IL-6 were also lower(P<0.01).On the first day of admission,BNP was positively correlated with APACHEⅡ score(r=0.44,P<0.01),BNP was positively correlated with TNF-α(r=0.53,P<0.01),BNP was positively correlated with IL-6(r=0.48,P<0.01).Conclusions The level of BNP in patients with sepsis increased significantly in the early stage.The BNP level of patients with sepsis with cardiac insufficiency was higher.The higher BNP level in the early stage often indicates the lower LVEF level,higher TNF-α and IL-6 level and the worse prognosis.For this kind of patients,we should pay more attention and intervene in time.

关 键 词：脓毒症 心功能不全 脑钠肽 左室射血分数 

分 类 号：R3[医药卫生—基础医学]