摘要
目的探讨脓毒症患者血清N末端前体脑尿钠肽(NT-proBNP)、血小板及胆固醇水平变化及意义。方法选取脓毒症43例,其中轻度脓毒症23例纳入轻度脓毒症组,严重脓毒症20例纳入重度脓毒症组;另选择同期住院的非脓毒症22例作为对照组。于入院后1、3、5 d分别检测3组NT-proBNP、血小板及胆固醇水平。结果入院后1 d轻度及重度脓毒症组NT-proBNP分别为(1086±569)μg/L和(2707±745)μg/L,显著高于对照组(165±20)μg/L,差异有统计学意义(P<0.001);血小板分别为(112±10)×109/L和(65±13)×109/L,胆固醇分别为(3.55±0.50)mmol/L,(2.17±0.57)mmol/L,均低于对照组(125±26)×109/L及(3.88±0.52)mmol/L,差异均有统计学意义(P<0.05或P<0.001)。入院后1 d与轻度脓毒症组比较,重度脓毒症组NT-proBNP明显增高,血小板及胆固醇明显下降,差异均有统计学意义(P<0.001)。在各检测时间点,重度脓毒症组3项指标变化与预后明显相关,随病程延长,该组死亡患者NT-proBNP水平逐步升高,血小板、胆固醇水平逐步降低;而存活患者则NT-proBNP水平逐步减低,血小板、胆固醇水平逐步回升,且呈时间依赖性,与入院后1 d比较差异均有统计学意义(P<0.05)。结论 NT-proBNP、胆固醇及血小板可作为脓毒症严重程度评价及预后预测的因子。
Objective To explore level changes and clinical significance of N-terminal pro-brain natriuretic peptide（NTproBNP）,blood platelet（PLT） and cholesterol in serum of patients with sepsis.Methods A total of 43 patients with sepsis were divided into two groups： mild sepsis group（group A,n = 23） and severe sepsis group（group B,n = 20）,and at the same time of 22 patients admitted not for septic were as the control group.Levels of NT-proBNP,PLT and cholesterol of the three groups were detected on the 1st,3rd and 5th d after hospitalization.Results After hospitalization,NT-proBNP levels in group A {（1086 ± 569） ng /ml} and group B {（2707 ± 745） ng / ml} were significantly higher than that {（165 ± 20） μg / L } in control group（P 0.001）;the levels of blood platelet and cholesterol in group A {（112 ± 10） × 109/ L,（3.55 ± 0.50） mmol / L} and group B {（65 ± 13） × 109/ L,（2.17 ± 0.57） mmol / L} were significantly lower than those {（125 ± 26） × 109/ L,（3.88 ± 0.52） mmol / L} in control group（P 0.05 orP 0.01）.On the 1st d after hospitalization comparing with group A,NT-proBNP level in group B increased obviously,but levels of blood platelet and cholesterol decreased obviously,and the differences were statistically significant（P 0.01）.In group B changes of the three indexes showed obvious correlation with prognosis on each detection point,and NT-proBNP level gradually increased,while levels of blood platelet and cholesterol gradually decreased in patients who died after prolonged disease course;NT-proBNP level gradually decreased,while levels of blood platelet and cholesterol gradually increased in surviving patients with time dependence,and there were significant differences comparing with those at the 1st d after hospitalization（P 0.05）.Conclusion NT-proBNP,cholesterol and blood platelet can be used as predictors of evaluating the severity and prognosis of sepsis.
出处
《临床误诊误治》
2013年第7期80-83,共4页
Clinical Misdiagnosis & Mistherapy
