血清N端脑钠肽前体和降钙素原水平在脓毒症患者中的表达及相关性分析

The expression and correlation analysis of serum n-terminal pro brain natriuretic peptide and procalcitonin in patients with sepsis

目的探讨血清N末端脑钠肽前体(NT-pro BNP)和降钙素原(PCT)水平在脓毒症患者中的表达水平及相关性。方法采集120例脓毒症患者和40例健康志愿者(对照组)。脓毒症患者按病情严重程度分为一般脓毒症组、严重脓毒症组、脓毒症休克组,每组各40例。按患者入院28d后预后情况,又分为存活组和死亡组。记录血清NT-pro BNP、PCT水平及急性生理和慢性健康状况(APACHE-Ⅱ)评分。结果与对照组相比,脓毒症各组的血清NT-pro BNP、PCT水平均明显增高,差异有统计学意义(P<0.05);随着脓毒症病情的加重,血清NT-pro BNP、PCT水平和APACHEⅡ评分明显升高,一般脓毒症组、严重脓毒症组、脓毒症休克组两两比较,差异有统计学意义(P<0.05)。死亡组患者的血清PCT、NT-pro BNP水平和APACHEⅡ评分明显高于存活组,差异有统计学意义(P<0.05)。血清NT-pro-BNP灵敏度和特异度为81.34%、86.27%,PCT为83.08%、88.61%。血清NT-proBNP水平和血清PCT水平呈正相关(r=0.826,P<0.05),血清NT-proBNP水平与APACHEⅡ评分呈正相关(r=0.756,P<0.05),血清PCT水平与APACHEⅡ评分也呈正相关(r=0.702,P<0.05)。结论血清NT-pro BNP和PCT水平对脓毒血症患者病情程度和生存情况的预测评估具有重要的临床应用价值。

Objective To investigate the expression and correlation of serum wterminal pro brain natriuretic peptide（NT-pro BNP） and procalcitonin in patients with sepsis. Methods A total of 120 patients with sepsis and 40 healthy volunteers（control group） were enrolled. Sepsis patients were divided into general sepsis group,severe sepsis group and septic shock group according to the severity of the disease,each group of 40 cases. According to the prognosis of patients admitted to hospital after 28 d,all patients were divided into survival group and death group. Serum NT-pro BNP,PCT levels and acute physiology and chronic health status scores （APACHE-Ⅱ ） were recorded. Results Compared with the control group, the serum levels of NT-pro BNP, PCT were significantly higher in sepsis group, and the difference was statistically significant （P〈0.05）;As sepsis progressed, serum NT-pro BNP,PCT level and APACHE Ⅱ score were significantly increased among 3 groups（P〈0.05）. The serum levels of PCT, serum NT-pro BNP and APACHE Ⅱ score in the death group were significantly higher than those in the survival group,and the difference was statistically significant （P〈0.05）. The sensitivity and specificity of serum NT-pro BNP were 81.34% and 86.27% and PCT was 83.08%and 88.61 %, respectively. The level of serum NT-pro BNP and serum PCT levels were positively correlated （r=0. 826,P〈0.05） ,the serum NT-pro BNP level correlated with the APACHE Ⅱ score positively （r=0. 756,P〈0.05） ,serum PCT level and APACHE Ⅱ score were positively correlated （r=0. 702,P〈0.05）. Conclusion Prediction and assessment of disease severity in patients with sepsis and survival have important clinical application value of serum NT-pro BNP and PCT levels in BNP.