脓毒症休克患者血清氨基末端脑钠肽前体水平变化及其与预后的相关性分析

Variation of serum amino-terminal pro-brain natriuretic peptide level and its correlation with prognosis in patients with septic shock

目的探讨脓毒症休克患者血清氨基末端脑钠肽前体(NT-pro BNP)水平变化及其与预后的相关性。方法对76例脓毒症患者临床资料进行回顾性分析,将30例出现休克的患者作为观察A组,46例未出现休克的患者作为观察B组。另选取同期一般感染患者40例作为对照组。比较3组患者入院时、入院12 h、入院24 h、入院48 h和入院72 h血清NT-pro BNP水平变化。将脓毒症休克患者分为死亡组和存活组,比较两组患者不同时刻血清NT-pro BNP水平变化,并分析和预后的临床关系。结果观察A组、观察B组和对照组NT-pro BNP水平比较,差异有统计学意义(P<0.05),各个时间点观察A组的NT-pro BNP水平高于其他两组,而观察B组均显著高于对照组。30例脓毒症休克患者中共有9例死亡、21例存活,各时间点死亡组患者NT-pro BNP水平高于存活组(P<0.05)。脓毒症休克患者血清NT-pro BNP水平和预后存在相关性(P<0.05),其NT-pro BNP水平越高患者预后越差。结论脓毒症休克患者血清NT-pro BNP水平比未发生休克和一般感染患者显著升高,其NT-pro BNP水平越高患者预后越差,NT-pro BNP可作为评估预后重要指标。

Objective To explore the variation of serum amino-terminal pro-brain natriuretic peptide（ NT-proBNP） level and its correlation with the prognosis in patients with septic shock. Methods The clinical data of 76 patients with sepsis were analyzed retrospectively.Thirty patients with shock were taken as observation A group and 46 patients without shock as observation B group. Forty patients with common infection during the same period were selected as control group. The variations of serum NT-proBNP levels were observed and compared among three groups at admission,after 12,24,48 and 72 hours of admission. The patients with septic shock were divided into death group and survival group,and the variations of serum NT-proBNP levels were compared between two groups at each time point. Then the clinical relationship of NT-proBNP level with prognosis was analyzed. Results There was significant difference in the NT-proBNP level among the observation A group,observation B group and control group（ P〈0. 05）. At each time point,the NT-proBNP level of the observation A group was significantly higher than those of the other two groups（ P〈0. 05）,and the level of the observation B group was significantly higher than that of the control group（ P〈0. 05）. Of 30 patients with septic shock,9 cases died and 21 survived. At each time point,the NT-proBNP level of the death group was higher than that of the survival group（ P〈0. 05）. The serum NT-proBNP level positively correlated with prognosis in the patients with septic shock（ P〈0. 05）,and the NT-proBNP level was higher when the prognosis got worse. Conclusion The serum NT-proBNP level of the patients with septic shock is significantly higher than that of the patients without shock or the patients with common infection,and the NT-proBNP level is higher when the prognosis gets worse. NT-proBNP level can be used as an important indicator for evaluating prognosis.