重症肺炎患者脑钠肽、乳酸水平与预后的关系.docVIP

重症肺炎患者脑钠肽、乳酸水平与预后的关系 　　[摘要] 目的 探讨重症肺炎患者脑钠肽、乳酸水平与预后的关系，为重症肺炎患者的救治提供临床参考。方法 收集重症肺炎患者116例，根据是否存活分为死亡组（n=48）和存活组（n=68）。比较两组患者在入院时、治疗后第3、5、7 d时血脑钠肽、乳酸水平变化和APACHE Ⅱ评分变化情况。并对血脑钠肽、乳酸水平与APACHE Ⅱ的相关性进行分析。结果 存活组入院后第3、5、7 d APACHE II评分、血乳酸、BNP水平明显低于入院时（P0.05）；死亡组入院后第3、5、7天 APACHE II评分、血乳酸、BNP水平明显高于入院时。存活组入院后不同时间点的APACHE II评分、血乳酸、BNP水平均明显低于死亡组（P0.05）。BNP与APACHE II评分呈明显的相关性（r=0.846，P=0.00）， 乳酸水平与APACHE II评分呈弱的相关性（r=0.364，P=0.00）。结论 动态检测BNP水平能更好的预测重症肺炎患者的预后，而血乳酸动态监测可作为辅助指标，以指导治疗，利于改善患者预后。 　　[关键词] 重症肺炎；脑钠肽；乳酸；预后 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）05（c）-0003-03 　　[Abstract] Objective To explore the relationship of level of brain natriuretic peptide and lactic acid with the prognosis in patients with severe pneumonia so as to provide a reference for the clinical treatment of the disease. Methods 116 patients with severe pneumonia were selected and divided into the death group（n=48） and the survival group （n=68） in accordance with whether the patients died or survived. The changes in plasma brain natriuretic peptide（BNP） and lactic acid levels and APACHE II score on admission， 3d， 5d and 7d after treatment were compared between the two groups. And the correlation of plasma BNP and lactic acid levels with APACHE II were analyzed. Results Compared with the APACHE II score， the level of plasma lactic acid and BNP on admission， the APACHE II score， level of plasma lactic acid and BNP on 3d， 5d and 7d after treatment was significantly lower in the survival group respectively（P0.05） and obviously higher in the death group， respectively. The APACHE II score， level of plasma lactic acid and BNP at different time points after admission in the survival group was significantly lower than that in the death group， respectively（P0.05）. There was significant correlation between the level of BNP and APACHEII score （r=0.846， P=0.00）， there was a weak correlation between lactic acid level and APACHE II score （r=0.364， P=0.00）. Conclusion Dynamic detection of BNP level can better predict t