PCT清除率及NT-proBNP动态变化与呼吸机相关性肺炎患者的预后研究  

The relationship between PCT clearance, NT proBNP dynamic changes and prognosis of patients with ventilator-associated pneumonia

作　　者：李学莉[1] 马晓曼[1] 李素琴[1] 姜城 王敏 卢燕[1] LI Xueli;MA Xiaoman;LI Suqin;JIANG Cheng;WANG Min;LU Yan(Intensive Care Unit,the First People′s Hospital of Yinchuan,Yinchuan 750001,China)

机构地区：[1]宁夏银川市第一人民医院ICU,宁夏银川750001

出　　处：《宁夏医学杂志》2022年第10期925-928,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(2020AAC03492);宁夏回族自治区卫生健康系统科研课题(2020256)。

摘　　要：目的 监测呼吸机相关性肺炎(VAP)患者降钙素原清除率(PCTc)及氨基末端脑钠肽前体(NT-proBNP)动态变化,探讨其与VAP患者预后的相关性。方法 在ICU确诊为VAP的患者92例,根据治疗效果分为好转组62例,恶化组30例。分别监测2组患者确诊VAP后第1、5、7、9 d血清降钙素原(PCT)和血浆NT-proBNP水平及第5、7、9 d血清PCTc。结果 好转组第5、7、9 d PCT清除率分别为(45.01±15.16)%、(70.76±9.45)%和(84.72±6.16)%;恶化组第5、7、9 d PCTc清除率分别为(-5.01±30.43)%、(-28.88±35.74)%和(-49.88±34.83)%,好转组PCTc显著高于恶化组,差异有统计学意义(P<0.05)。好转组第1、5、7、9 d NT-proBNP水平分别为(598.95±175.90)pg/mL、(662.94±155.80)pg/mL、(522.03±241.21)pg/mL和(397.55±95.10)pg/mL;恶化组第1、5、7、9 d NT-proBNP水平分别为(613.23±188.38)pg/mL、(941.50±118.97)pg/mL、(1135.80±169.61)pg/mL和(1458.00±288.01)pg/mL,好转组NT-proBNP水平明显低于恶化组,差异有统计学意义(P<0.05)。结论 持续动态观察PCT及NT-proBNP,进行PCTc分析较仅关注PCTc更具有优势,PCTc低水平和NT-proBNP高水平则提示VAP患者的不良预后。Objective To monitor the procalcitonin clearance rate(PCTc)and the dynamic changes of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in patients with ventilator associated pneumonia(VAP)and to explore the correlation between the parameters and the prognosis of VAP patients.Method 92 patients diagnosed as VAP in ICU were divided into improvement group(n=62)and deterioration group(n= 30).The levels of serum PCT and plasma NT-proBNP on the 1st, 5th, 7th and 9th day after the diagnosis of VAP and the clearance rate of serum PCT on the 5th, 7th and 9th day were monitored.Result The clearance rates of PCT on the 5th,7th and 9th day in the improved group were(45.01±15.16) %,(70.76±9.45) % and(84.72±6.16) %,respectively.The clearance rate of PCT in the deteriorated group was(-5.01±30.43) %,(-28.88±35.74) % and(-49.88±34.83) % on the 5th,7th and 9th day,respectively.The clearance rate of PCT in the improved group was significantly higher than that in the deteriorated group,and the difference was statistically significant(P<0.05).The levels of NT-pro BNP were(598.95±175.90) pg/mL,(662.94 ±155.80) pg/mL,(522.03±241.21) pg/mL and(397.55±95.10) pg/mL.The levels of NT-pro BNP were(613.23±188.38) pg/mL,(941.50±118.97) pg/m L on the 1st,5th,7th and 9th day,respectively.The level of NT-pro BNP in the improved group was significantly lower than that in the deteriorated group,and the difference was statistically significant(P<0.05).Conclusion Continuous dynamic observation of PCT and NT-pro BNP and analysis of PCT clearance rate have more advantages than only focusing on PCT,and low PCT clearance rate and high NT-pro BNP level indicate poor prognosis of VAP patients.

关 键 词：呼吸机相关性肺炎 降钙素原清除率 氨基末端脑钠肽前体 预后 

分 类 号：R563.8[医药卫生—呼吸系统]