脓毒性休克患者血浆脑钠肽水平升高持续时间对预后的研究

The prognostic study of the rise duration of plasma B-type natriuretic peptide in the patients with septic shock

目的探讨血浆B型脑钠肽（B-type natriuretic peptide,BNP）水平升高持续时间对脓毒性休克患者预后判断的价值。方法收集入住院ICU 150例脓毒性休克患者的BNP水平升高持续时间、急性生理学及慢性健康状况评分Ⅱ（APACHEⅡ评分）、初始血浆BNP水平和预后的相关资料。根据预后分为存活组（110例）和死亡组（40例）,比较两组患者BNP水平升高持续时间、APACHEⅡ评分、初始血浆BNP水平的差异;以BNP水平升高持续时间分为A组（〈48h,48例）、B组（48-96h,56例）和C组（〉96h,46例）,比较三组患者病死率的差异。结果各组入住ICU时APACHEⅡ评分、初始血浆BNP水平比较差异均无统计学意义（P〉0.05）;存活组BNP水平升高持续时间为（38.2±15.1）h,明显低于死亡组（65.5±16.4）h（P〈0.05）;C组病死率（52.2%）明显高于A、B两组（10.4%与19.6%）（P〈0.01）。结论 BNP水平升高持续时间可用于评估脓毒性休克患者治疗效果和预后。

Objective To investigate the prognostic value of the rise duration of plasma B- type natriuretic peptide（BNP）in the patients with septic shock. Methods Totally 150 patients with septic shock admitted to Intensive Care Unit（ICU）in our hospital were enrolled. The rise duration of BNP,acute physiology and chronic health evaluation Ⅱ score（APACHEⅡ score）,the levels of BNP on admission to ICU and prognosis of the patients were measured. According to theresults of following up,the patients were divided into survival group（S-group,n=110）and non-survival group（NS-group,n=40）. The rise duration of BNP,APACHEⅡ score,the levels of BNP on admission to ICU were compared between the twogroups. Based on the rise duration of BNP,the patients were divided into group A（〈48 h,n=48）,group B（48-96 h,n=56）andgroup C（〉96 h,n=46）,mortality was compared among the three groups. Results On admission to ICU,there were nostatistical significance in the general condition,APACHEⅡ score and the levels of BNP of patients among the groups（P〉0.05）. The rise duration of BNP in S-group was（38.2±15.1）h,which was significantly lower than that of NS-group（65.5±16.4）h（P〈0.05）. The mortality of group C（52.2%）was significantly higher than those of group A and group B（10.4% and19.6%）（P〈0.01）.Conclusion The rise duration of BNP could be used to evaluate the effectiveness of treatment andprognosis of patients with septic shock.