脓毒症患者血清脑钠肽水平与APACHEⅡ评分的研究

The relationship between brain natriuretic peptide and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)in patients with sepsis

目的探讨脓毒症患者血清脑钠肽(BNP)水平与急性生理学与慢性健康情况评价系统Ⅱ(APACHEⅡ)评分的变化。方法选取北京市石景山医院103例脓毒症患者测定入院后24 h内的血清BNP、C-反应蛋白(CRP)、白细胞(WBC)等,按照APACHEⅡ评分分为三组:低危组(n=32)、中危组(n=41)和高危组(n=30),比较三组间血清BNP水平的变化。按照28d结局分为两组:存活组(n=75)和死亡组(n=28),比较两组间血清BNP的变化。结果中危组脓毒症患者血清BNP水平显著高于低危组脓毒症患者[(903±105)ng/L vs(521±97)ng/L,P<0.01],高危组脓毒症患者血清BNP显著高于中危组脓毒症患者[(1 501±197)ng/L vs(903±105)ng/L,P<0.01]。死亡组脓毒症患者血清BNP较存活组明显升高[(1 239±208)ng/L vs(465±120)ng/L,P<0.01)]。结论血清BNP水平与APACHEⅡ评分密切相关,血清BNP水平是预测脓毒症预后的较为敏感的指标。

Objective To explore the relationship between brain natriuretic peptide（ BNP） and acute physiology and chronic health evaluation Ⅱ（APACHEⅡ） in sepsis patients. Methods Totally 103 patients were divided into three groups：low score group（ n = 32）,media score group（n = 41）and high score group（n = 30）according to APACHEⅡ scores. Based on the 28- day outcomes of patients,the patients were divided into survival group（n = 75）and death group（n = 28）. The difference of BNP,C-reactive protein（CRP） and white blood cell（WBC）between the above groups was compared. Results The serum levels of BNP were significantly higher in patients with media score than that in patients with low score [（903 ± 105）ng / L vs（521 ± 97）ng / L,P 〈 0. 01],and the serum levels of BNP were significantly higher in patients with high score than that in patients with median score [（1 501 ± 197） ng / L vs（903 ± 105）ng / L,P 〈 0. 01]. The serum levels of BNP were significantly higher in death group than that in survival group [（1 239 ± 208） ng / L vs（465 ± 120）ng / L,P 〈 0. 01]. Conclusion The serum level of BNP is associated with BNP,which can be used for predicting the outcomes of septic patients.