ICU血流感染患者血清BNP、suPAR、MMP-9水平及临床意义  

Clinical significance of serum BNP,suPAR and MMP-9in ICU patients complicated with bloodstream infection

作　　者：魏芳[1] 吴桂琼 孙建[1] WEI Fang;WU Gui-qiong;SUN Jian(Lishui Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院重症监护室,浙江丽水323000

出　　处：《中华医院感染学杂志》2021年第17期2678-2682,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医学会临床科研基金资助项目(2018ZYC-A159)。

摘　　要：目的探讨重症监护病房(ICU)血流感染患者血清B型脑钠肽(BNP)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、基质金属蛋白酶-9(MMP-9)水平改变及临床意义。方法选取2017年3月-2019年11月丽水市中心医院收治的80例ICU血流感染患者为感染组,另选择同期ICU病房收治的30例非血流感染患者纳入非感染组,测定患者血清BNP、suPAR、MMP-9水平,通过受试者工作特征曲线(ROC)评估血清BNP、suPAR、MMP-9水平对ICU血流感染鉴别及预后评估的价值。结果80例血流感染患者,血培养共分离病原菌91株,其中革兰阳性菌47株占51.65%,革兰阴性菌39株占42.86%,真菌5株占5.49%;感染组血清BNP、suPAR、MMP-9含量高于非感染组(P<0.05);血清BNP、suPAR、MMP-9诊断ICU血流感染的ROC曲线下面积分别为0.920、0.893、0.906;感染组患者中死亡患者血流感染诊断后第1天、第3天、第5天血清BNP、suPAR、MMP-9含量高于存活患者(P<0.05)。结论ICU血流感染患者血清BNP、suPAR、MMP-9含量升高,动态观察血清BNP、suPAR、MMP-9水平有助于患者的预后评估。OBJECTIVE To explore the changes and clinical significance of serum B-type natriuretic peptide(BNP),soluble urokinase plasminogen activator receptor(suPAR)and matrix metalloproteinase-9(MMP-9)in the intensive care unit(ICU)patients complicated with bloodstream infection.METHODS A total of 80ICU patients complicated with bloodstream infection who were treated in the Lishui Central Hospital from Mar 2017to Nov 2019 were assigned as the infection group,meanwhile,30ICU with non-bloodstream infection were set as the non-infection group.The levels of serum BNP,suPAR and MMP-9of the patients were detected,and the value of serum BNP,suPAR and MMP-9in differential diagnosis of bloodstream infection and assessment of prognosis was evaluated by means of receiver operating characteristic(ROC)curve.RESULTS Totally 91strains of pathogens were isolated from the 80patients with bloodstream infection through blood culture,47(51.65%)of which were grampositive bacteria,39(42.86%)were gram-negative bacteria,and 5(5.49%)were fungi.The levels of serum BNP,suPAR and MMP-9of the infection group were significantly higher than those of the non-infection group(P<0.05).The areas under ROC curve of the BNP,suPAR and MMP-9were respectively 0.920,0.893and 0.906in diagnosis of bloodstream infection in the ICU patients.Among the patients in the infection group,the levels of serum BNP,suPAR and MMP-9of the dead patients were significantly higher than those of the survived patients after the patients were diagnosed with bloodstream infection for 1,3and 5days(P<0.05).CONCLUSIONThe levels of serum BNP,suPAR and MMP-9of the ICU patients complicated with bloodstream infection are elevated,and the dynamic monitoring of serum BNP,suPAR and MMP-9may facilitate the assessment of prognosis.

关 键 词：重症监护病房 血流感染 B型脑钠肽 可溶性尿激酶型纤溶酶原激活物受体 基质金属蛋白酶-9 

分 类 号：R446.1[医药卫生—诊断学]