脓毒症患者血浆PCT 、NT pro BNP与cTnT水平检测的临床意义

目的探讨脓毒症患者血浆降钙素原（PCT）、氨基末端脑钠肽前体（NT pro BNP）与肌钙蛋白T（cTnT）水平是否存在相关，以及对患者预后的意义。方法选取2014年9月-2015年3月某院重症监护病房（ICU）收治的48例脓毒症患者，按严重程度分成重度和轻度两组，检测患者血浆中PCT、 NT pro BNP及cTnT水平，并统计患者的死亡结局情况，比较分析两组患者血浆PCT、NT pro BNP、cTnT水平与其死亡情况的关系。结果重度脓毒症组患者血浆中PCT、NT pro BNP、cTnT水平均高于轻度脓毒症组患者，差异具有统计学意义（均P＜0.05）；轻度脓毒症患者病死率为10.53%，低于重度脓毒症患者（41.38%），差异有统计学意义（P＜0.05）；死亡组患者的PCT、NT pro BNP与cTnT水平均高于存活组（均P＜0.05）；相关分析发现脓毒症患者血浆中PCT 与NT pro BNP呈正相关（rs=0.337，P＜0.05），NT pro BNP与cTnT之间也呈正相关（rs＝0.456，P=0.001)，而PCT与cTnT无显著相关。 预后分析发现脓毒症患者血浆中PCT、NT pro BNP、cTnT水平均与患者预后相关（P＜0.05)，并且对患者的预后均有较好的判别作用，与独立指标相比，当三个指标组合时对预后判别能力更好。结论联合检测脓毒症患者血浆PCT、NP pro BNP与cTnT水平可评估脓毒症患者感染的严重程度，并初步判断脓毒症患者的预后。

Clinical significance of detection of plasma PCT, NT pro BNP and cTnT levels in patients with sepsis

ObjectiveTo evaluate whether there is a correlation among plasma levels of procalcitonin (PCT), N terminal pro brain natriuretic peptide (NT pro BNP) and cardiac troponin T (cTnT) in patients with sepsis, as well as significance to prognosis of patients. Methods48 patients with sepsis who were admitted to the intensive care unit of a hospital between September 2014 and March 2015 were chosen for study, patients were divided into severe and mild sepsis groups according to the disease condition, plasma levels of PCT, NT pro BNP, and cTnT were detected, mortality of patients were analyzed statistically, relation between plasma levels of PCT, NT pro BNP, cTnT and patients’ death were compared. ResultsThe plasma levels of PCT, NT pro BNP and cTnT in severe sepsis group were significantly higher than those in mild sepsis group (all P＜0.05); mortality of mild sepsis group was significantly lower than that of severe sepsis group (10.53% vs 41.38%, P＜0.05); Levels of PCT, NT pro BNP and cTnT levels in died patients were all higher than surviving patients ( all P<0.05); levels of PCT and NT pro BNP, NT pro BNP and cTnT were positively correlated respectively (rs= 0.337, P＜0.05; rs＝0.456，P=0.001, respectively ), while PCT was not significantly correlated with cTnT. Plasma levels of PCT, NT pro BNP, and cTnT were all correlated with the prognosis of patients (P＜0.05), and is helpful for judging the prognosis of patients, combination of three indexes had better prognostic value for the prognosis.ConclusionCombination detection of plasmid levels of PCT, NP pro BNP, and cTnT can assess the severity of infection in patients with sepsis, and preliminarily judge the prognosis of patients with sepsis.