B型钠尿肽与非心脏病ICU患者严重程度及近期预后的相关性研究

Recent correlation of severity and prognosis of B-type natriuretic peptide to no heart disease patients in ICU

目的探讨B型钠尿肽（BNP）与非心脏病ICU患者严重程度及近期预后的相关性。方法对2010年3月至2012年3月我院ICU病房的60例危重症患者，分别在入院时、24h进行急性生理和慢性健康状况评分系统Ⅱ（APACHEⅡ）评分及测定血清BNP浓度，分析两者与危重症患者的病死率、住院时间、机械通气的时间等主要预后指标的关系。结果60例患者存活42例，死亡18例，病死率为30％，其中死亡组APACHEII评分（26．46±11．61）分和血清BNP浓度（2154．26±1126．49）ng／L，均明显高于存活组（13．45±4．20）分和（1058．16±857．83）ng／L（t值分别为6．4055和4．1190，P均〈0．001），APACHEⅡ评分、机械通气的时间及病死率随BNP浓度升高而升高（F值分别为49．089、22．754、36．398，P均〈0．001）。结论BNP和APACHEⅡ评分的升高对危重症患者的存活、机械通气时间、住院时间等主要预后指标的预测有重要意义。

Objective To investigate the correlations of short-term prognosis and B-type natriuretic peptide（BNP） of no heart disease patients in ICU. Methods Sixty patients of critically ill in our ICU ward from March 2010 to March 2012 were taken scores of acute physiology and chronic health II scoring system （APACHE II score） and determination serum BNP level in 24 hours of admission and analysis mortality in hospital time, mechanical ventilation time and other major prognostic indicators. Results Forty-two cases were living, 18 cases were dead in the 60 cases （ mortality rate 30% ） . APACHE II score （ 26. 46 ± 11.6 ） and serum BNP concentrations （2154. 26 ± 1126.49 ） ng/L were significantly higher in death cases than in living cases （ 13.45± 4. 20） vs. （ 1058.16 ± 857. 83 ） ng/L （ t = 6. 4055,4. 1190, P 〈 0. 001 ）, mechanical ventilation time mortality rate both also increase with BNP levels （ F = 49. 089,22. 754, 36. 398 respectively, P 〈 0. 001 ）. Conclusion BNP level and APACHE II score rise of survival of critically ill patients have important prognostic significance with duration of mechanical ventilation,length of hospital stay prognostic indicators forecast.