B型利钠肽和乳酸对老年脓毒症患者的评估价值

The Clinical Value of B-type Natriuretic Peptide and Blood Lactic Acid in Assessment of the Elderly Patients With Sepsis

目的研究老年脓毒症患者血浆B型利钠肽、血乳酸升高与病情和预后的关系;探讨B型利钠肽(BNP)与血乳酸(LAC)、急性生理学及慢性健康状况评分系统(APACHEⅡ评分)之间的相关性。方法 56例老年脓毒症患者按照确诊分为:脓毒血症组23例,严重脓毒症组20例,脓毒症休克组13例,比较各组的血浆BNP、血乳酸以及APACHEⅡ评分的差异。随访28天,分析死亡组和存活组患者的血浆BNP、血乳酸以及APACHEⅡ评分的差异。结果血浆BNP、乳酸及APACHEⅡ评分随着脓毒症严重程度的增加而增高,三组之间差异有统计学意义(P=0.000)。脓毒症患者中死亡组患者的血BNP、LAC及APACHEⅡ评分较存活组升高,差异有统计学意义(P=0.000)。脓毒症各组患者中血浆BNP与乳酸及APACHEⅡ评分呈正相关的关系,差异有统计学意义。结论血浆BNP、乳酸对老年脓毒症患者病情严重程度及预后具有判断价值。

Objective To study the relationship of between B-type natriuretic peptide, elevated blood lactate and the illness in elderly patients with sepsis, and research the impact of B-type natriuretic peptide and lactic acid concentration on the prognosis of elder patients; The correlation between B-type natriuretic peptide and blood lactic acid, acute physiology and chronic health evaluation （APACHE Ⅱ score） were analyzed in elderly patients with sepsis Methods 56 elderly patients with sepsis were divided into three groups： sepsis group（diagnosed With sepsis, 23 cases）,severe sepsis group（diagnosed with severe sepsis,20 cases） and septic shock（diagnosed With Septic shock, 13 cases）.The indexes of BNP, LAC and the scores, of APACHE Ⅱ were compared among threegroup.s After 28 days＇following up, the above clinical data were compared between death group and survival group. The indexes of BNP, LAC and the scores of APACHE Ⅱ were compared among two groups. Results The plasma BNP, the blood lactic acid and the scores of APACHE Ⅱ in the three groups were increased with the severity of sepsis ,the plasma BNP, the blood lactic acid and the scores of APACHE Ⅱ： in the three groups had ＇significant difference in statistics （P=0.000）. The value of BNP, LAC and the scores of APACHE Ⅱ in death group among the sepsis patients were higher than those in survival group, and the difference was statistically significant （P=0.000）. In sepsis group, The plasma BNP and LAC, the scores of APACHE Ⅱ were determined with positive linear correlation respectively, and the difference was statistically significant. Conclusion Plasma BNP level and blood lactic acid are the valuable factor on the severity and prognosis in elderly patients with sepsis.