B型利钠肽对脓毒症患者病情及预后的预测价值

The Predictive Value of B-type Natriuretic Peptide on the Severity and Prognosis in Patients with Sepsis

目的:探讨B型利钠肽(BNP)判断脓毒症患者病情及预后的价值。方法:测定并比较2013年3月至2014年6月我科收治的感染性休克组(n=55)和严重脓毒症组(n=70)于入住ICU 0 h、24 h、48 h、72 h的血浆BNP水平;并根据住院28 d死亡情况分为死亡组(n=31)和存活组(n=94),并比较两组血浆BNP水平差异。结果:感染性休克组各时点的血浆BNP水平均显著高于严重脓毒症组(P均<0.01);死亡组血浆BNP水平在入ICU的各时点均显著高于存活组(P均<0.01);感染性休克组的血浆BNP水平与急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官功能衰竭评分(SOFA)均有较好相关性。结论:血浆BNP对脓毒症患者病情严重程度及预后具有判断价值。

Objective： To explore the predictive value of B-type natriuretic peptide （BNP） on the severity and prognosis in patients with sepsis. Methods： The plasma BNP levels were measured and compared at 0 h, 24 h,48 h and 72 h after admission to the intensive care unit（ICU） in septic shock group（n=55）and sever sepsis group（n=70） from Mar 2013 to Jun 2014.The cases were also divided into death group（n=31） and survival group（n=94） according to 28-day mortality. Results： The levels of plasma BNP in septic shock group were significantly higher than those in sever sepsis group at all time points, all P 〈 0.01. The levels of plasma BNP in death group were also significantly higher than those in survival group , and the difference persited to 72 hours;Correlation analysis showed that in the septic shock patients at all time points, all P 〈 0.01.There were positive correlations between BNP level and acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ）, sequential organ failure assessment （SOFA）. Conclusion： Plasma BNP level is a valuable factor on the severity and prognosis in patients with sepsis.