PICCO及BNP监测指标对老年感染性休克预后的预测作用

目的:探讨PICCO监测指标及BNP(B型脑钠肽)对老年感染性休克患者预后的预测作用。方法:26例ICU收治的老年感染性休克患者分为存活组(n=12)和死亡组(n=14)。记录患者的一般情况及急性生理和慢性健康评分;利用PICCO监护仪监测心脏指数、胸腔内血容积指数、血管外肺水指数、体循环阻力指数;采用荧光免疫测定法进行血浆BNP检测;统计患者住院期间存活或死亡及相应的住院病死率。评价PICCO监测指标和血浆BNP与病死率的关系。结果:存活组CI值高于死亡组,EV-LWI、PVPI低于死亡组(P<0.05),其他PICCO监测指标差异无统计学意义,死亡组血浆BNP水平明显高于存活组(P<0.05)。结论:部分PICCO监测指标如CI可能是影响老年感染性休克患者预后的危险因素,而血浆BNP也对老年感染性休克患者预后判断有重要意义。

Predictive value of pulse indicator continuous monitoring of cardiac output and Brain Natriuretic Peptide in the prognosis of elderly septic shock patients

Objective: To investigate the predictive value of pulse indicator continuous monitoring of cardiac output and Brain Natriuretic Peptide in the prognosis of elderly septic shock patients.Methods: Twenty-six elderly septic shock patients admitted to the intensive care unit were enrolled and divided into survival group(n=12) and death group(n=14).General situation,acute physiology and chronic health score were recorded,PICCO was applied to monitor the cardiac index,intrathoracic blood volume index,extravascular lung water index,systemic venous resistance index,and plasma BNP was measured with fluorescence immunoassay method.Number of survived or dead patients and related mortality was recorded.Relationship between indexes monitored with PICCO and serum BNP and mortality were evaluated.Results: CI of the survival group were higher than that of the death group,while EVLWI and PVPI were lower(P<0.05).No significant difference in other monitored indexes was observed.Serum BNP level of the death group was significant higher than that of the survival group.Conclusions: CI may be a risk factor which probably affects the prognosis of elderly patients with infectious shock,while BNP is important index in predicting its prognosis.