血清降钙素原与B型尿钠肽在感染性休克患者体液复苏治疗前后的检测意义

Significance of serum procalcitonin and B-type natriuretic peptide detection before and after fluid resuscitation in patients with septic shock

目的探讨感染性休克体液复苏治疗前后血清降钙素原(PCT)与B型尿钠肽(BNP)的检测意义。方法抽取河南省人民医院2020年1月至2022年1月收治的64例感染性休克患者为研究对象,所有对象均接受体液复苏治疗。检测治疗前后血清PCT、BNP及其他指标(如氧分压、二氧化碳分压、pH值、钠离子、氯离子等)。比较64例患者体液复苏治疗前后治疗相关指标。根据预后将患者分为存活组(50例)与死亡组(14例),比较两组治疗前及治疗后1、2、3 d血清PCT与BNP水平。结果体液复苏治疗后,64例感染性休克患者氧分压、二氧化碳分压与治疗前比较差异未见统计学意义(P>0.05);治疗后,患者pH值、PCT降低,而钠离子、氯离子及BNP升高,差异有统计学意义(P<0.05)。治疗前,存活组与死亡组PCT、BNP水平比较差异未见统计学意义(P>0.05);治疗后1、2、3 d,两组PCT逐渐降低,BNP逐渐升高(P<0.05),且存活组PCT低于死亡组,BNP高于死亡组(P<0.05)。结论感染性休克患者体液复苏治疗后血清PCT下降,而BNP升高,可为感染性休克患者的预后评估提供依据。

Objective To investigate the significance of serum procalcitonin(PCT)and B-type natriuretic peptide(BNP)detection before and after fluid resuscitation in patients with septic shock.Methods Sixty-four patients with septic shock treated in Henan Provincial People’s Hospital from January 2020 to January 2022 were selected.All subjects received body fluid resuscitation therapy.Serum PCT,BNP and other indicators(such as oxygen partial pressure,carbon dioxide partial pressure,pH,sodium ion,chloride ion)were detected before and after treatment.The related treatment factors of the 64 patients were compared before and after fluid resuscitation.According to prognosis,they were divided into survival group(50 cases)and death group(14 cases).And the serum PCT and BNP levels were compared between the two groups before treatment and on 1,2,3 d after treatment.Results There was no significant difference in comparison on preoprative and postoperative oxygen partial pressure and carbon dioxide partial pressure in the 64 patients(P>0.05);after treatment,pH value and PCT decreased significantly,while sodium ion,chloride ion and BNP increased significantly in the 64 patients(P<0.05).There was no significant difference in PCT and BNP between the survival group and death group before treatment(P>0.05).The PCT in the two groups decreased on 1,2 and 3 d after treatment,but the BNP increased(P<0.05);and the PCT level in the survival group was lower than that in the death group,and the BNP level was higher than that in the death group 1,2,3 d after treatment(P<0.05).Conclusions Serum PCT level will decrease,while BNP will increase significantly in patients with septic shock after body fluid resuscitation.And the two indicators can provide a reference for prognosis prediction.