血浆脑利钠肽和降钙素原水平评估脓毒性休克患儿预后的临床意义

Clinical significance of plasma brain natriuretic peptide level and procalcitonin in evaluation of pediatric septic shock prognosis

目的探讨血浆脑利钠肽(BNP)和降钙素原(PCT)在小儿脓毒性休克检测中的临床意义方法 50例脓毒性休克患儿,根据入院时小儿危重病例评分法分为非危重组(35例)和危重组(15例)对两组血浆BNP和PCT水平进行比较,对存活患儿急性期和恢复期的血浆BNP和PCT水平进行比较并对死亡患儿BNP和PCT的相关性进行分析。结果危重组血浆BNP和PCT水平明显高于非危重组差异有统计学意义(P<0.05);存活患儿急性期血浆BNP和PCT水平明显高于恢复期,差异有统计学意义(P<0.05);将死亡患儿入院时血浆BNP和PCT进行Spearman秩相关的非参数统计方法分析,结果显示血浆BNP和PCT呈正相关(r=0.9821)。结论监测血浆中BNP和PCT水平对评估脓毒性休克患儿病情制定诊疗措施及判断预后具有重要的临床意义。

Objective To investigate clinical significance of plasma brain natriuretic peptide（BNP） and procalcitonin（PCT） in detection of pediatric septic shock. Methods A total of 50 children with septic shock were divided by their admission severity scores into non-severe group（35 cases） and severe group（15 cases）. Comparison was made on plasma BNP and PCT levels between the two groups. Plasma BNP and PCT levels in acute phase and recovery phase of survived children were compared, and correlation between plasma BNP and PCT in dead children was analyzed. Results The severe group had obviously higher plasma BNP and PCT than the non-severe group, and the difference had statistical significance（P〈0.05）. Survived children had much higher plasma BNP and PCT than in acute phase than in recovery phase, and the difference had statistical significance（P〈0.05）. Spearman nonparametric statistics of rank correlation was applied to analyze admission plasma BNP and PCT in dead children, and the outcomes showed positive correlation between plasma BNP and PCT（r=0.9821）. Conclusion Detection of plasma BNP and PCT levels shows important clinical significance for evaluation of pediatric septic shock, establishment of treatment measures, and judgment of prognosis.