BNP、TnT和TnI水平对预测重症脓毒症和脓毒症休克患者预后的临床意义

摘要

目的：探讨监测脑利钠肽、肌钙蛋白T和肌钙蛋白I对重症脓毒症及脓毒症休克患者预后的意义。方法回顾性分析重症脓毒症和脓毒症休克患者58例的临床资料。其中重度脓毒症28例，脓毒症休克30例。监测患者确诊当天BNP、TnT和TnI水平。分析BNP、TnT和TnI水平与患者预后的关系。结果重症脓毒症组患者TNT水平显著低于脓毒症休克组（P＜0.01）。死亡患者BNP、TNT及TNI水平显著高于存活患者（P＜0.01）。BNP对预测死亡具有统计学意义（ROC下面积0.794，P＜0.01），TNT对预测死亡具有统计学意义（ROC下面积0.527，P＜0.05）。结论BNP、TnT对重症脓毒症及脓毒症休克患者的预后具有预测作用。%Objective To investigate the significance of monitoring brain natriuretic peptide,troponin T and troponin I in predicting the prognosis of patients with severe sepsis and septic shock. Methods Clinical data of 58 patients with severe sepsis and septic shock were analyzed retrospectively, of which 28 patients had severe sepsis and 30 patients had septic shock.The patients'BNP,TnT and TnI levels on the day of definite diagnosis were monitored.The relationship between the BNP,TnT and TnI levels and the patients'prognosis was analyzed. Results The severe sepsis group had significantly lower TnT level than the septic shock group(P < 0.01). The dead patients had significantly higher BNP, TnT and TnI levels than the survived patients(P<0.01). BNP had statistical significance in predicting death(area under ROC was 0.794,P<0.01) and TNT had statistical significance in predicting death(area under ROC was 0.527,P < 0.05). Conclusion BNP and TnT have predictive effect for the prognosis of patients with severe sepsis and septic shock.