血浆心钠素及脑钠素检测对预测老年重度脓毒症并发心功能异常及预后的价值

目的 探讨老年重度脓毒症患者血浆心钠素及脑钠素检测对预测心功能异常及不良预后的价值和意义。方法 采用巢式病例对照研究方法，43名老年重度脓毒症患者于确诊后次日测血浆心钠素和脑钠素浓度，并连续3d超声监测患者心功能以确定其是否并发心功能异常并分组，比较两组心钠素和脑钠素浓度，并通过工作曲线下面积比较以确定心钠素和脑钠素对预测心功能异常及不良预后的价值。结果 老年重度脓毒症患者血浆心钠素和脑钠素均能预测心功能异常的发生，但脑钠素预测价值较高。心钠素和脑钠素对死亡预测价值均不高。结论 血浆脑钠素可以作为预测老年重度脓毒症患者合并心功能异常较好的生物学指标。

Significance of atrial natriuretic polypeptide and brain natriuretic peptide in predicting cardiac dysfunction and outcome of elderly severe sepsis patients

Objective To explore the value and significance of atrial natriuretic polypeptide(ANP) and brain natriuretic peptide(BNP) in predicting cardiac dysfunction and outcome of severe sepsis of elderly patients.Methods Nest case control study was conducted.ANP and BNP were detected in 43 elderly patients with severe sepsis in the next morning of diagnosis.Cardiac function was monitored in 3 consecutive days for the identification of cardiac dysfunction.The patients were divided into groups for the comparison of ANP and BNP.The areas under ROC of ANP and BNP were measured and compared to evaluate the value of ANP and BNP in predicting cardiac dysfunction and outcome.Results Both ANP and BNP could predict the presence of cardiac dysfunction in the elderly severe sepsis patients,but BNP was superior to ANP.ANP and BNP had limited value in predicting outcome of elderly severe sepsis patients.Conclusion BNP may be a good biomarker in predicting cardiac dysfunction of elderly severe sepsis patients.