血必净注射液对老年脓毒症患者N末端B型脑钠肽前体及疾病预后的影响

The effects of Xuebijing injection on levels of N terminal B type natriuretic peptide and prognosis in senile patients with sepsis

目的观察老年脓毒症患者N末端B型脑钠肽前体（NT—proBNP）水平的变化及与疾病严重程度的相关性，并探讨血必净注射液对NT—proBNP及疾病预后的影响。方法选择2010年3月～2013年8月我院ICU收治的老年脓毒症患者62例，分为对照组和血必净治疗组。分别记录患者治疗前和治疗后第3天、第7天的体温变化，并于第1、3、7天分别取静脉血检测白细胞、中性粒细胞、C反应蛋白（CRP）、降钙素原（PCT）、NT—proBNP水平；观察患者APACHE1I评分变化、机械通气时间、人ICU24小时后多器官功能障碍综合征（MODS）发生率和28天病死率。结果治疗组患者接受血必净治疗7天后NT．proBNP、CRP、PCT分别为（976±481）pg/ml、（61±25）mg／L、（11．7±8．9）ng／ml，与对照组的（1126±468）pg／ml、（82±23）mg／L和（15．4±9．2）ng／ml比较均明显降低，差异均有统计学意义（P〈0．05）。血必净治疗组MODS发生率与28天病死率分别为16．1％和22．6％与对照组的41．9％和48．4％比较，均明显下降（P〈0．05）。结论老年脓毒症患者NT—proBNP普遍升高并与疾病严重程度相关，血必净注射液可明显降低其水平，改善疾病预后。

Objective To observe the correlation between the levels of NT-proBNP and the se- verity of sepsis in elderly patients and to investigate the effects of Xuebijing injection on the levels of NT- proBNP and the prognosis of this disease. Methods Sixty-two elderly patients with sepsis （without cardi- ac and renal dysfunction） treated in the ICU of our hospital from Mar. 2010 to Aug. 2013 were divided in- to the control group and the Xuebijing treatment group. The temperature of the patients in both groups were recorded before treatment,at the 3rd and at the 7th day after treatment. The levels of leucocyte, neutro- phil, c-reactive protein（ CRP）, procalcitonin （PCT） and NT-proBNP. inboth groups were tested at the 1 st, 3rd and 7tb day after treatment Acute Physiology and Chronic Health Evaluation （APACHE） II score changes, time of mechanical ventilation, MODS incidence after 24 hours of ICU treatment and the mortali- ty in 28 days were also observed in both groups. Results The levels of NT-proBNP,CRP,PCT were lower in the Xuebijing treatment group than those in the control group （ P 〈 O. 05 ） ; MODS incidence and the mortality in 28 days were lower in the Xuebijing treatment group than those in the control group （ P 〈 0.05 ）. Conclusion NT-proBNP levels were high in the elderly patients and correlated with the severity of sepsis. Xuebijing injection could remarkably decrease the levels of NT-proBNP and improve the progno- sis of this disease in the elderly.