氨基末端B型钠尿肽前体及肌钙蛋白I对脓毒症预后预测价值.docVIP

氨基末端B型钠尿肽前体及肌钙蛋白I对脓毒症预后预测价值 　　 　　[摘要] 目的 评价氨基末端B型钠尿肽前体（NT-pro-BNP）及肌钙蛋白I（cTnI）对脓毒症预后判断的作用。 方法 入选住院的脓毒症患者66例，按病情严重程度，分为一般脓毒症组（24例）、严重脓毒症组（22例）及脓毒症休克组（20例）；根据患者的28天生存率，分为死亡组（20例）和存活组（46例）。在入院24小时内检测血清cTnI、NT-pro-BNP及降钙素原（PCT）水平，并进行急性生理和慢性健康状况评分Ⅱ（APACHEⅡ评分），比较各组血清cTnI、NT-pro-BNP、PCT水平及APACHEⅡ评分，分析NT-pro-BNP、cTnI水平与PCT水平、APACHEⅡ评分的相关性。 结果 脓毒症休克组的血清NT-pro-BNP、cTnI、PCT水平及APACHEⅡ评分明显高于严重脓毒症组及一般脓毒症组，差异具有统计学意义（P0.05）。严重脓毒症组的血清NT-pro-BNP、cTnI、PCT水平及APACHEⅡ评分高于一般脓毒症组，差异具有统计学意义（P0.05）。死亡组的血清cTnI、NT-pro-BNP、PCT水平及APACHEⅡ评分明显高于生存组（P0.05）。血清NT-pro-BNP、cTnI水平与PCT呈正相关（r分别=0.901，0.866，P0.05），血清NT-pro-BNP、cTnI水平与APACHEⅡ评分呈正相关（r=0.602、0.521，P 0.05）。 结论 血清cTnI与NT-pro-BNP联合检测可以作为常规临床检测指标来判断脓毒症患者的预后。 　　[关键词] 脓毒症；氨基末端B型钠尿肽前体；肌钙蛋白I；降钙素原；APACHEⅡ评分；预后 　　[中图分类号] R714.251[文献标识码] A[文章编号] 1674-4721（2014）05（b）-0017-04 　　 　　Predictive value of N-terminal pro-brain natriuretic peptide and cardiac troponin I for prognosis of sepsis 　　LEI Yan LUO Yu-zhen ZHAO Ying-ping ZHANG Hui LI Chao-liang WANG Hai-qin 　　Department of Intensive Care Unit,Jiangmen Center Hospital Affiliated to Sun Yat-sen University,Jiangmen 529030,China 　　[Abstract] Objective To evaluate the role of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac troponin I for prognosis of sepsis. Methods 66 patients with sepsis admitted into our hospital were divided into the general sepsis group (n=24),the severe sepsis group (n=22) and the sepsis shock group (n=20) according to patients′ condition.Meanwhile the patients were divided into the survival group (n=46) and the death group (n=20) according to 28 days′survival rate of patients. The serum NT-pro-BNP,cTnI and PCT level were measured and APACHE Ⅱ score were conducted when the patients stayed in ICU in 24 hours.The serum NT-pro-BNP, cTnI and PCT level and the APACHE Ⅱ score among three groups were compared. The correlation of NT-pro-BNP,cTnI and PCT,APACHE Ⅱ score were analyzed. Results The serum NT-pro-BNP,cTnI and PCT level and the APACHE Ⅱ score in the sepsis