CAJ | 학술논문

目的：探讨血浆N末端脑钠肽前体（NT-proBNP）对严重脓毒症和脓毒症休克患者预后的判断价值。方法选择该院收治的脓毒症患者70例，根据患者病情严重程度分为一般脓毒症组（n＝23）、严重脓毒症组（n＝28）和脓毒症休克组（n＝19），于入院1 h内测定患者血浆NT-proBNP、乳酸、C反应蛋白（CRP），并计算24 h急性生理和慢性健康状态评分Ⅱ（APACHEⅡ）。结果（1）严重脓毒症组、脓毒症休克组患者血浆NT-proBNP、乳酸、CRP和 APACHEⅡ明显高于一般脓毒症组（P＜0．05）；脓毒症休克组患者血浆NT-proBNP、CRP和 APACHEⅡ明显高于严重脓毒症组（P＜0．05）。（2）70例脓毒症患者死亡15例，存活55例，死亡组血浆NT-proBNP、乳酸、CRP和APACHEⅡ明显高于存活组（P＜0．01）。（3）脓毒症患者入院时NT-proBNP浓度与APACHEⅡ呈正相关（r＝0．528，P＜0．01）。结论血浆NT-proBNP与脓毒症患者预后密切相关，早期检测血浆NT-proBNP水平有助于评估脓毒症患者预后情况。
목적：탐토혈장N말단뇌납태전체（NT-proBNP）대엄중농독증화농독증휴극환자예후적판단개치。방법선택해원수치적농독증환자70례，근거환자병정엄중정도분위일반농독증조（n＝23）、엄중농독증조（n＝28）화농독증휴극조（n＝19），우입원1 h내측정환자혈장NT-proBNP、유산、C반응단백（CRP），병계산24 h급성생리화만성건강상태평분Ⅱ（APACHEⅡ）。결과（1）엄중농독증조、농독증휴극조환자혈장NT-proBNP、유산、CRP화 APACHEⅡ명현고우일반농독증조（P＜0．05）；농독증휴극조환자혈장NT-proBNP、CRP화 APACHEⅡ명현고우엄중농독증조（P＜0．05）。（2）70례농독증환자사망15례，존활55례，사망조혈장NT-proBNP、유산、CRP화APACHEⅡ명현고우존활조（P＜0．01）。（3）농독증환자입원시NT-proBNP농도여APACHEⅡ정정상관（r＝0．528，P＜0．01）。결론혈장NT-proBNP여농독증환자예후밀절상관，조기검측혈장NT-proBNP수평유조우평고농독증환자예후정황。
Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .