老年脓毒症血浆氨基末端脑钠肽前体和肌钙蛋白I 临床价值.docVIP

老年脓毒症血浆氨基末端脑钠肽前体和肌钙蛋白I 临床价值 　　【摘要】目的通过联合检测老年脓毒症患者血浆氨基末端脑钠肽前体（NT-proBNP）和肌钙蛋白I （cTnI）质量浓度，评价其对老年脓毒症患者的病情评估及预后判断的临床意义。方法用前瞻性研究方法，以2011年1月至2013年1月在解放军总医院第一附属医院急诊留观及急诊病房住院的老年脓毒症患者145例为研究对象，其中一般脓毒症组84例、严重脓毒症组45例、脓毒性休克组16例。来院后立即检测血浆NT-proBNP和cTnI质量浓度，行超声心动图检查测定LVEF值，进行APACHEⅡ评分。随访严重脓毒症及脓毒性休克组患者28 d生存情况，对存活组（49例）及死亡组（12例）患者检测的各项指标进行比较；并比较NT-proBNP和cTnI与APACHEⅡ评分的相关性。结果血浆NT-proBNP和cTnI在严重脓毒症组[（1375.48±537.15）pg/mL，（0.53±0.45）μg/L]和脓毒性休克组[（2735.73±907.17）pg/mL，（1.94±1.14） μg/L]的质量浓度明显高于一般脓毒症组[（554.12±107.48）pg/mL，（0.08±0.07）μg/L]， 三组间比较差异均具有统计学意义（P 　　【关键词】老年人；脓毒症；严重脓毒症；脓毒性休克；氨基末端脑钠肽前体；肌钙蛋白I；射血分数；预后 　　Clinical value of N-terminal pro-brain natriuretic peptide and troponin I plasma levels in elderly patients with sepsis SU Qin， ZHANG Xian， Yao Ya-bin， CHEN Li-ping， GAO Shi-bo， LIU Dong-sheng， LIU Yang， YAO Yong-ming， ZHAO Xiao-dong.Department of Emergency， First Affiliated Hospital， General Hospital of PLA， Beijing 100048， China 　　【Abstract】ObjectiveTo evaluate the clinical significance for assessment and prognosis of elder patients with sepsis by way of detecting plasma NT-proBNP and cTnI levels. MethodsIt was a prospective trial conducted. A total of 145 elderly patients with sepsis were admitted to the emergency observation center and the emergency ward from January 2011 through January 2013. Of them， there were 84 patients with mild sepsis， 45 patients with severe sepsis， and 16 patients with septic shock. Plasma levels of NT-proBNP and cTnI were assayed immediately after admission. The LVEF value was determined by echocardiography. The APACHEⅡ score was also determined. In the following 28 days， the survival of patients with severe sepsis and septic shock were investigated. Data of laboratory findings were analyzed for comparison between the survival group （n=49） and death group （n=12）. ResultsThe plasma levels of NT-proBNP and cTnI in the severe sepsis group[（1375.48±537.15）pg/mL，（0.53±0.45）μg/L]and in the septic shock group [（2735.73±907.17）pg/mL，（1.94±1.14） μg/L]we