CAJ | 학술논문

目的检测脓毒症患者血液中脑钠肽表达的变化，探讨其相关的临床意义。方法收集2011年12月～2012年12月急诊ICU收治的脓毒症患者74例，另取同期健康体检者40名作为正常对照。74例脓毒症患者分为轻度组（APACHEⅡ≤10， n=22）、中度组（11＜APACHEⅡ＜20，n=32）和重度组（APACHEⅡ≥21，n=20）。脑钠肽表达的测定使用ELISA法。结果脓毒症患者脑钠肽的表达水平显著高于健康对照组（P＜0.01）。轻度组、中度组和重度组脓毒症患者脑钠肽的表达水平之间具有显著性差异（P＜0.05）；其中重度组显著高于中度组（P＜0.05），中度组又显著高于轻度组（P＜0.01）。第1、3、7天时恶化组脑钠肽的表达水平均显著高于好转组（P＜0.01），随着时间的推移好转组脑钠肽的表达水平逐渐降低（P＜0.05），而恶化组脑钠肽的表达水平则逐渐升高（P＜0.05）。结论脑钠肽表达的升高可能参与了脓毒症病变的发生、发展过程，脑钠肽的检测有可能成为脓毒症患者的早期诊断以及预后评估指标。
목적검측농독증환자혈액중뇌납태표체적변화，탐토기상관적림상의의。방법수집2011년12월～2012년12월급진ICU수치적농독증환자74례，령취동기건강체검자40명작위정상대조。74례농독증환자분위경도조（APACHEⅡ≤10， n=22）、중도조（11＜APACHEⅡ＜20，n=32）화중도조（APACHEⅡ≥21，n=20）。뇌납태표체적측정사용ELISA법。결과농독증환자뇌납태적표체수평현저고우건강대조조（P＜0.01）。경도조、중도조화중도조농독증환자뇌납태적표체수평지간구유현저성차이（P＜0.05）；기중중도조현저고우중도조（P＜0.05），중도조우현저고우경도조（P＜0.01）。제1、3、7천시악화조뇌납태적표체수평균현저고우호전조（P＜0.01），수착시간적추이호전조뇌납태적표체수평축점강저（P＜0.05），이악화조뇌납태적표체수평칙축점승고（P＜0.05）。결론뇌납태표체적승고가능삼여료농독증병변적발생、발전과정，뇌납태적검측유가능성위농독증환자적조기진단이급예후평고지표。
Objective To investigate the expression and clinical significance of brain natriuretic peptide(BNP) in patients with sepsis.Methods A total of 74 cases of patients with sepsis were enrolled in our study.Another 40 healthy people were used as a normal control.Patients were devided into three groups:light group(APACHEⅡ≤10,n=22),middle group(11<APACHEⅡ<20,n=32),and heavy group(APACHEⅡ≥21,n=20).The expression of BNP was detected by ELISA analysis.Results The expression of BNP in sepsis group was 171.2±26.1pg/mL,and which was higher than that of 37.5±7.4pg/mL in control group(P<0.01).The expression of BNP in light group,middle group,and heavy group was 82.4±13.2pg/mL,156.5±24.7pg/mL,and 281.2±34.6pg/mL.There was significant difference among the three groups(P<0.05),which was higher in heavy group than that in middle group(P<0.05),and middle group than that in light group(P<0.01).The expression of BNP in improve group was 146.2±25.8pg/mL,118.6±22.1pg/mL,and 90.5±11.4pg/mL at 1,3,7 day.The expression of BNP in deterioration group was 288.6±35.3pg/mL,326.3±43.4pg/mL,and 386.4±52.6pg/mL at 1,3,7 day.The BNP expression was higher in deterioration group than that in improved group at 1,3,7 day(P<0.01).The expression of BNP in improved group was decreased,according to time reducing(P<0.05).The expression of BNP in deterioration group was increased, according to time reducing(P<0.05).Conclusion The overexpression of BNP may be involved in the occurrence and development of sepsis,which might be used as a mark to estimate the degree of differentiation or prognosis of sepsis.