重度烧伤休克期监测N端脑钠肽前体的临床意义  

Clinical Significance of Monitoring NT-proBNP in Shock Stage of Severe Burn

作　　者：储丹 CHU Dan(The Affiliated Hospital of Nankai University,Tianjin Fourth Hospital,Tianjin,300222,China)

机构地区：[1]南开大学附属医院(天津市第四医院),天津300222

出　　处：《黑龙江医学》2022年第10期1177-1179,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨重度烧伤患者休克期内N端脑钠肽前体(NT-proBNP)血清水平的变化特点,对于重度烧伤早期诊疗的临床意义。方法:选取2020年1月—2021年12月南开大学附属医院(天津市第四医院)收治的符合实验研究标准的96例烧伤科患者。根据烧伤面积分为:A、B、C三组为实验组,另外选取同期入院的30例烧伤整容患者作为对照组。测定并分析实验组和对照组所有患者入院时NT-proBNP、肌钙蛋白Ⅰ值(cTnⅠ)、肌酸激酶同工酶(CK-MB)的血清水平。测定各实验组,在休克期内各时间点(伤后8 h、16 h、24 h、48 h、72 h)的NT-proBNP的血清数值,并分析其变化特点。测定重度烧伤患者(B、C组)在伤后8 h、16 h、24 h、48 h、72 h的NT-proBNP及c TnⅠ的血清浓度,并分析两项指标血清水平改变的特点与关联。结果:与对照组比较各实验组间的CK-MB血清水平,差异无统计学意义(P>0.05)。而NT-proBNP与cTnⅠ的血清数值在重度烧伤组(B、C组)中出现显著性上升的改变。烧伤休克期内,血清NT-proBNP的血清数值随着烧伤面积的增大、烧伤时间的推移,呈现明显的上升趋势,差异有统计学意义(P<0.05)。重度烧伤患者(B、C组)在休克期内NT-proBNP的血清水平持续显著上升。cTnⅠ的血清数值于8 h~24 h呈显著增高,24 h达到高峰,48 h数值下降,与同期NT-proBNP的血清水平走势相逆,出现“分离”现象。结论:NT-proBNP的血清水平能敏锐反映重度烧伤患者在烧伤早期存在的心功能不全。NT-proBNP的血清数值与患者的烧伤面积、及是否发生严重并发症等因素密切相关,可作为临床判断伤情、评估预后的特异性指标。Objective: To investigate the changes of serum level of N-terminal pro-brain natriuretic peptide(NT-proBNP) in severe burn patients during shock, and its clinical significance for early diagnosis and treatment of severe burn. Methods: A total of 96 burn patients admitted to the hospital who met the experimental from January 2020 to Decembet 2021 research standards were selected. According to the burn area, three groups, A, B, and C, were divided into the experimental group, and 30 cases of burn surgery patients who were admitted to the hospital during the same period were selected as the control group. The serum levels of NT-proBNP, troponin Ⅰ(cTnⅠ) and creatine kinase isoenzyme(CK-MB) were measured and analyzed in all patients in the experimental group and control group at admission. The serum values of NT-proBNP were measured in each experimental group at various time points(8 h, 16 h, 24 h, 48 h, and 72 h after injury) during the shock period, and the change characteristics were analyzed. Serum concentrations of NT-proBNP and c Tn Ⅰ were measured in severe burn patients(groups B and C) at 8 h, 16 h, 24 h,48 h, and 72 h after injury, and the characteristics and correlations of serum levels of the two indexes were analyzed. Results:Compared with the control group, there was no significant difference in the serum levels of CK-MB between the experimental groups(P>0.05). The serum values of NT-proBNP and c TnⅠ increased significantly in the severe burn groups(groups B and C).During the burn shock period, the serum NT-proBNP level showed an obvious upward trend with the increase of the burn area and the burn time, and the difference was statistically significant(P<0.05). Serum levels of NT-proBNP continued to significantly increase in severe burn patients(groups B and C) during the shock period. The serum value of cTnⅠ increased significantly from 8 h to 24 h, reached a peak at 24 h, and decreased at 48 h, which was opposite to the trend of serum level of NT-proBNP in the same period, and the phenomenon of

关 键 词：重度烧伤 N端脑钠肽前体 休克期 心功能不全 预后 

分 类 号：R644[医药卫生—外科学]