血浆N末端脑钠肽前体对严重脓毒症和脓毒症休克患者预后判断的价值

The value of prognosis of NT-proBNP in severe sepsis and septic shock patients

目的探讨血浆N末端脑钠肽前体(NT-proBNP)对严重脓毒症和脓毒症休克患者预后的判断价值。方法选择该院收治的脓毒症患者70例,根据患者病情严重程度分为一般脓毒症组(n=23)、严重脓毒症组(n=28)和脓毒症休克组(n=19),于入院1h内测定患者血浆NT-proBNP、乳酸、C反应蛋白(CRP),并计算24h急性生理和慢性健康状态评分Ⅱ(APACHEⅡ)。结果 (1)严重脓毒症组、脓毒症休克组患者血浆NT-proBNP、乳酸、CRP和APACHEⅡ明显高于一般脓毒症组(P<0.05);脓毒症休克组患者血浆NT-proBNP、CRP和APACHEⅡ明显高于严重脓毒症组(P<0.05)。(2)70例脓毒症患者死亡15例,存活55例,死亡组血浆NT-proBNP、乳酸、CRP和APACHEⅡ明显高于存活组(P<0.01)。(3)脓毒症患者入院时NT-proBNP浓度与APACHEⅡ呈正相关(r=0.528,P<0.01)。结论血浆NT-proBNP与脓毒症患者预后密切相关,早期检测血浆NT-proBNP水平有助于评估脓毒症患者预后情况。

Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group （n=23） ,severe sepsis group（n=28） and sep-tic shock group（n=19） according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） .Results （1） Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group（P〈 0 .05）;Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group （P〈0 .05） .（2）70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients（P〈0 .01） .（3） Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores（r=0 .528 ,P〈0 .01） .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .