脓毒症患儿血浆N-末端B型利钠肽原变化研究

目的 观察N-末端B型利钠肽原(NT-proBNP)在脓毒症合并心力衰竭患儿中的水平变化.方法 本院儿科重症监护病房(PICU)住院的脓毒症患者36例,其中合并心力衰竭25例(A组),非心力衰竭11例(B组),健康对照者20例(C组).测定入院后24小时内血浆NT-proBNP及肌钙蛋白I(cTnI)的水平,比较各组之间血浆NT-proBNP及cTnI差异.结果 A、B、C组NT-proBNP水平入院后分别为(4 876.7±1 934.5) ng/L,(1 374.7±256.1) ng/L,(456.2±165.1) ng/L,对比各组入院后NT-proBNP的水平,差异有统计学意义(P＜0.01).cTnI在A、B、C组分别为(2.56±0.78) ng/L,(0.09±0.02) ng/L,(0.03±0.01) ng/L,A组最高,3组差异亦有统计学意义(P ＜0.01).结论 NT-proBNP在脓毒症患者血浆中水平升高,且在心力衰竭患者与非心力衰竭患者中差异有统计学意义,可作为判断心肌功能是否受损的指标.

Clinal study of plasma NH2 terminal pro-brain natriuretic peptide in patients with sepsis

Objective To observe the variation of NH2 terminal pro-brain natriuretic peptide（NT-proBNP） level in patients with sepsis and heart failure. Methods We recruited 36 patients whose diagnoses of sepsis were confirmed according to the diagnosis and treatment in 2002. The patients were divided into heart failure group （group A, n = 25） and non-heart failure group （group B, n = 11）, meanwhile, twenty health subjects were enrolled as control group （group C, n =20）. NT-proBNP in plasma in 36 patients and 20 health subjects were measured and then the differences among the three groups were analyzed. Meanwhile, the results of troponin I（cTnI） were compared in three groups. Results There were significant differences in NT-proBNP levels among three groups, group A （4 876.7± 1 934.5） ng/L,group B （1 374.7±256.1） ng/L,and group C （456.2±165.1） ng/L（ P 〈0.01）, cTnI in three groups showed significance difference,group A （2.56±0.78）ng/L,group B （0.09±0.02） ng/L,group C （0.03±0.01） ng/L （ P 〈0.01） ,group A was the highest. Conclusion NT-proBNP in plasma is significantly higher in patients with sepsis, and the levels are different in sepsis combined with heart failure and without heart failure. The concentration of NT-proBNP can be used as the laboratory marker for detection of early heart failure and myorcardial functional lesion.