BNP的检测在危重烧伤患者病情评估中的临床应用价值

The clinical application value of BNP detection in the evaluation of critical burn patients

目的分析BNP的检测及变化趋势在危重烧伤患者病情评估中的临床应用价值。方法选取2018年7月至2019年12月本院收治的危重烧伤患者52例作为研究对象,根据患者是否伴有心衰将所有患者分为心衰组与非心衰组,各26例。所有患者在受伤后的第3、7、14天进行静脉血抽取,并使用免疫荧光法检测患者血液中的BNP浓度及变化趋势,观察非心衰组与心衰组患者各个时间点的BNP水平、脓毒症程度和死亡率。结果非心衰组患者在入院第3天BNP水平为(289.75±27.42)ng/L、第7天BNP水平为(225.46±21.35)ng/L、第14天BNP水平为(189.61±17.85)ng/L,与心衰组患者在第3、7、14天BNP水平对比,差异有统计学意义(P<0.05);非心衰组患者的脓毒症比例为65.38%、严重脓毒症比例为23.08%、脓毒性休克比例为11.54%,与心衰组患者的脓毒症比例、严重脓毒症比例、脓毒性休克比例对比,差异具有统计学意义(P<0.05);非心衰组患者的死亡率为3.85%,明显低于心衰组患者的死亡率19.23%,差异具有统计学意义(P<0.05)。结论对危重烧伤患者进行BNP检测,动态监测其变化趋势,可以了解患者病情,初步估计预后,值得临床推广应用。

Objective To analyze the clinical value of BNP detection and change trend in the evaluation of critical burn patients.Methods From July 2018 to December 2019,52 severely burned patients in our hospital were selected as the study subjects.According to whether the patients have heart failure,all patients were divided into heart failure group and non heart failure group,with 26 cases in each group.On the 3rd,7th and 14th day after injury,all patients were given venous blood sampling,and the BNP concentration and change trend were detected by immunofluorescence method.The BNP level,sepsis degree and mortality of patients in non heart failure group and heart failure group were observed.Results The BNP level of the patients in the non heart failure group was(289.75±27.42)ng/L on the third day,(225.46±21.35)ng/L on the seventh day and(189.61±17.85)ng/L on the fourteenth day(P<0.05),the difference was statistically significant compared with the BNP level of the patients in the heart failure group on the third,seventh and fourteenth day;the sepsis rate of the patients in the non heart failure group was 65.38%and the serious sepsis rate was 23.08%,the proportion of septic shock was 11.54%,which was statistically significant compared with that of sepsis,severe sepsis and septic shock in patients with heart failure(P<0.05).The mortality of non heart failure group was 3.85%,which was significantly lower than that of heart failure group(19.23%),the difference was statistically significant(P<0.05).Conclusion BNP detection and dynamic monitoring of the trend of change in critically burned patients can help us to understand the patient's condition and estimate the prognosis,which is worth popularizing and applying.