重症肺炎患者血清NT-proBNP和HMGB1水平的变化及其意义

Changes of serum levels of NT-proBNP and HMGB1 in patients with severe pneumonia and their significance

目的探讨重症肺炎患者血清N末端脑钠肽前体(NT-pro BNP)和高迁移率族蛋白B1(HMGB1)水平变化及在判断患者预后中的意义。方法 96例重症肺炎患者分为存活组(59例)和死亡组(37例),选取健康者40例作为对照组,分别于重症肺炎患者入院第1、3、5和7天时,以及对照组体检当天,对血清NT-pro BNP和HMGB1水平进行检测,并记录急性生理学与慢性健康状况(APACHEⅡ)评分。结果重症肺炎患者第1天血清NT-pro BNP和HMGB1水平与对照组比较,差异有统计学意义(P<0.05)。与第1天比较,存活组患者第3、5和7天时血清NT-pro BNP、HMGB1水平和APACHEⅡ评分降低;死亡组患者第3天血清NT-pro BNP、HMGB1水平降低,而第5和7天时血清NT-pro BNP和HMGB1水平升高,死亡组患者第3、5和7天时APACHEⅡ评分升高(P<0.05)。存活组患者第1、3、5和7天血清NT-pro BNP、HMGB1水平、APACHEⅡ评分与死亡组比较,差异有统计学意义(P<0.05);Pearson相关分析显示,重症肺炎患者血清NT-pro BNP水平与APACHEⅡ评分呈正相关(P<0.05),血清HMGB1水平与APACHEⅡ评分呈正相关(P<0.05)。结论重症肺炎患者血清NT-pro BNP、HMGB1水平与患者病情严重程度和预后有关,可作为评估病情和判定预后的辅助指标。

Objective To investigate the changes of serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and high mobility group box 1 protein （HMGB1） in the patients with severe pneumonia and their significance in prediction of prognosis. Methods Totally 96 patients with severe pneumonia were divided into survival group （59 cases） and death group （37 cases）. In the same period, 40 healthy subjects were selected as control group. The serum levels of NT-proBNP and HMGB1 were measured and the APACHE Ⅱ scores were recorded for all severe pneumonia patients on day 1, 3, 5 and 7 after admission, and in the control group on the examination day. Results The serum levels of NT-proBNP and HMGB1 on day 1 in the patients with severe pneumonia were higher than those in the control group （P〈0.05）. Compared with the values on day 1, the serum levels of NT-proBNP and HMGB1 and the APACHE Ⅱ scores in the survival group decreased on day 3, 5 and 7; the serum levels of NT-proBNP and HMGB1 in the death group decreased on day 3 but increased on day 5 and 7, the APACHE Ⅱ scores in the death group increased on day 3, 5 and 7 （P〈0.05）. The serum levels of NT-proBNP and HMGB1 and APACHE Ⅱ scores on day 1, 3, 5 and 7 in the survival group were lower than those in the death group （P〈0.05）. Pearson correlation analysis showed that the serum levels of NT-proBNP and HMGB1 in the patients with severe pneumonia were positively correlated with APACHE Ⅱ scores （P〈0.05）. Conclusions The serum levels of NT-proBNP and HMGB1 in the patients with severe pneumonia increase, and are correlated with the severity and prognosis of the patients. They could be used as adjuvant indicators for assessment of disease and prognosis.