氨基末端脑钠肽前体联合肌钙蛋白Ⅰ评估脓毒症预后的研究

Application of amino terminal brain natriuretic peptide precursor combined with troponin Ⅰ in evaluating the prognosis of sepsis

目的研究血浆氨基末端脑钠肽前体(NT-pro-BNP)联合肌钙蛋白Ⅰ(cTnT-Ⅰ)指标联合检测在评估创伤性脓毒症患者预后康复质量中的应用价值。方法将2016年8月-2018年8月于本院接受诊治的78例创伤性脓毒症患者作为观察对象,参照患者的病情严重程度分成一般性脓毒症组(42例)、严重性脓毒症组(36例);另选取同期于本院接受健康体检的40例正常者作为对照组;探讨脓毒症患者血浆NT-pro-BNP、cTnT-Ⅰ表达水平和APACHEⅡ评分的相关性。结果一般性脓毒症组、严重性脓毒症组患者的血浆NT-pro-BNP、cTnT-Ⅰ表达水平与APACHEⅡ评分均高于对照组,严重性脓毒症组高于一般性脓毒症组,差异有统计学意义(P<0.05);相较于存活组,死亡组患者的NT-pro-BNP、cTnT-Ⅰ表达水平与APACHEⅡ评分均显著增高(P<0.05);血浆NT-pro-BNP表达水平与cTnT-Ⅰ表达水平呈正相关(r=0.733,P<0.05);血浆NT-pro-BNP、cTnT-Ⅰ表达与APACHEⅡ评分呈正相关(r值分别为0.647、0.578,P<0.05)。结论血浆氨基末端脑钠肽前体联合肌钙蛋白Ⅰ指标联合检测在评估创伤性脓毒症患者预后康复质量中应用价值高,利于临床评估患者的病情严重程度、判断预后康复质量,值得临床推广。

Objective To study the detection value of plasma amino terminal pro-brain natriuretic peptide(NT-pro-BNP) combined with troponin Ⅰ(cTnT-Ⅰ) in the evaluation of prognosis quality in patients with traumatic sepsis. Methods Seventy-eight cases of patients with traumatic sepsis who were treated in our hospital from August 2016 to August 2018 were enrolled in this study. According to the patient’s severity, the patients were divided into general sepsis group(42 cases), severe sepsis group(36 cases). Another 40 cases of normal people who received a physical examination at the same time were selected as the control group. To investigate the correlation between plasma NT-pro-BNP, cTnT-Ⅰ expression and APACHEⅡ score in patients with sepsis. Results The levels of plasma NT-pro-BNP and cTnT-Ⅰ and APACHEⅡ scores in general sepsis group and severe sepsis group were higher than those in the control group(P<0.05). Compared with the general sepsis group, that in the severe sepsis group were significantly higher, with the differences statistically significant(P<0.05). And compared to the survival group, that in the death group were also higher(P<0.05). The Plasma NT-pro-BNP expression levels and cTnT-Ⅰ expression levels were positively correlated in patients with sepsis(r=0.733, P<0.05). Plasma NT-pro-BNP, cTnT-Ⅰ expression and APACHEⅡ score were positively correlated(r=0.647, r=0.578, P<0.05). Conclusion The combined detection of plasma amino terminal brain natriuretic peptide and troponin Ⅰ in the evaluation of prognosis quality in patients with traumatic sepsis is of high value, which is conducive to the clinical evaluation of the severity of patients and the quality of prognosis. It is worthy of clinical promotion.