B型利钠肽对脓毒症患者病情及预后的预测价值

摘要

目的：探讨B型利钠肽（BNP）判断脓毒症患者病情及预后的价值。方法：测定并比较2013年3月至2014年6月我科收治的感染性休克组（n＝55）和严重脓毒症组（n＝70）于入住 ICU 0 h、24 h、48 h、72 h 的血浆BNP 水平；并根据住院28 d 死亡情况分为死亡组（n＝31）和存活组（n＝94），并比较两组血浆 BNP 水平差异。结果：感染性休克组各时点的血浆 BNP水平均显著高于严重脓毒症组（P 均＜0．01）；死亡组血浆 BNP 水平在入ICU 的各时点均显著高于存活组（P 均＜0．01）；感染性休克组的血浆 BNP 水平与急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分和序贯器官功能衰竭评分（SOFA）均有较好相关性。结论：血浆BNP对脓毒症患者病情严重程度及预后具有判断价值。%Objective: To explore the predictive value of B-type natriuretic peptide (BNP) on the severity and prognosis in patients with sepsis. Methods: The plasma BNP levels were measured and compared at 0 h,24 h,48 h and 72 h after admission to the intensive care unit(ICU) in septic shock group(n=55)and sever sepsis group(n=70) from Mar 2013 to Jun 2014.The cases were also divided into death group(n=31) and survival group(n=94) according to 28-day mortality. Results: The levels of plasma BNP in septic shock group were significantly higher than those in sever sepsis group at all time points,all P < 0.01. The levels of plasma BNP in death group were also significantly higher than those in survival group ,and the difference persited to 72 hours;Correlation analysis showed that in the septic shock patients at all time points,all P < 0.01.There were positive correlations between BNP level and acute physiology and chronic health evaluation Ⅱ(APACHEⅡ),sequential organ failure assessment (SOFA). Conclusion:Plasma BNP level is a valuable factor on the severity and prognosis in patients with sepsis.