严重感染及感染性休克患者血清脑钠肽变化及其对心功能预后的预测作用

The predictive values of B-type natriuretic peptide for the heart function and prognosis in patients with severe sepsis and septic shock

目的:探讨严重感染及感染性休克患者血清脑钠肽(BNP)变化及其对心功能预后的预测作用。方法:对我院68例严重感染及感染性休克的患者进行前瞻性研究,68例患者进入重症监护病房(ICU)24 h内测动脉血BNP及左心室射血分数(LVEF)。根据患者LVEF水平分为心功能正常组和心功能不全组,比较两组患者BNP水平;患者住院28 d死亡19例作为死亡组,存活49例,作为存活组,回顾性分析两组BNP水平,用ROC曲线评价BNP预测死亡的临界值。结果:①心功能不全组患者BNP水平显著高于心功能正常组患者BNP水平(P<0.05)。②死亡组患者BNP水平显著高于存活组BNP水平(P<0.05),患者BNP水平>691.8 ng/L为预测死亡的临界值,敏感度为91.7%,特异度为80.7%。结论:严重感染及感染性休克患者BNP水平显著升高,BNP对于患者心功能的预后具有一定的预测价值。

Objective： To study the predictive values of B-type natriuretic peptide for the heart function and prognosis in patients with severe sepsis and septic shock.Methods： 68 patients of severe sepsis and septic shock were prospectively studied,68 patients into ICU were tested BNP and left ventricular ejection fraction measured arterial blood（LVEF） in 24 h,dividing the patients into the normal heart function and heart failure group according to LVEF,BNP levels were compared between two groups,19 patients died as the 28 d hospital death group,49 survived,as the survival group,retrospective analysis of two groups of BNP,BNP predicted by ROC curve analysis threshold of death.Results： ① BNP in patients with heart failure group was significantly higher than normal cardiac function in patients with BNP level group（P0.05）.② BNP level of the death group was significantly higher than that of the survival group,BNP level 691.8 ng/L was critical value for the prediction of death,the sensitivity was 91.7%,specificity was 80.7%（P0.05）.Conclusion： Severe sepsis and septic shock patients are significantly higher BNP levels,and BNP levels have a predictive value for the patients to prognosis of heart function.