血清氨基末端脑钠肽前体/胆碱酯酶比值评估脓毒症患者的临床研究

目的探讨血清氨基末端脑钠肽前体(NT-proBNP)/胆碱酯酶(ChE)水平比值在评估脓毒症患者病情及预后的临床价值。方法 107例ICU脓毒症患者24h内进行急性生理学及慢性健康状况评分系统(APACHEⅡ)评分,同时检测血清NTproBNP及ChE水平,按患者病情分为轻度脓毒症组(C组),严重脓毒性及脓毒性休克组(S组),分析NT-proBNP、ChE、NTproBNP/ChE、APACHEⅡ评分与患者预后关系。结果 S组中死亡和存活患者ChE、NT-proBNP/ChE、APACHEⅡ评分比较,差异有统计学意义(P0.05),而C组中差异无统计学意义(P0.05);S组中APACHEⅡ评分、ChE、NT-proBNP/ChE与预后有显著相关(P0.05),NT-proBNP与预后无相关(P0.05)。C组中NT-proBNP、ChE、NT-proBNP/ChE、APACHEⅡ评分与预后均无相关(P0.05)。结论 NT-proBNP/ChE比值可作为严重脓毒症及脓毒性休克患者病情及预后的预测因素,具有一定的临床应用价值。

Clinical study on the application of ratio of serum N-terminal pro-brain natriuretic peptide and ChE in patients with sepsis

Objective To investigate the clinical value of ratio of serum N-terminal pro-brain natriuretic peptide(NT-proBNP) and acetylcholinesterase(ChE)in evaluating the severity and prognosis of patients with sepsis .Methods A total of 107 ICU patients with sepsis within 24 hours were evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) ,at the same time se-rum concentrations of NT-proBNPand ChE were detected ,according to the patient′s condition ,107 patients were divided into mild sepsis group(group C) ,severe and shock sepsis group(group S) ,the correlations of NT-proBNP ,ChE ,NT-proBNP/ChE ,APACHEⅡ score and prognosis in patients were analyzed .Results The ChE ,NT proBNP/ChE ,APACHE Ⅱ score between death and sur-vival patients in group S had significant differences(P< 0 .05) ,but there were no significant differences in group C(P> 0 .05) .Bina-ry logistic regression analysis showed APACHE Ⅱ score ,ChE ,NT-proBNP/ChE in group S had correlation with prognosis of pa-tients(P< 0 .05) ,and NT-proBNPin group S had no correlation with prognosis of patients(P> 0 .05) .The indexes and prognosis in group C showed no correlation(P> 0 .05) .Conclusion NT-proBNP/ChE score has a certain application value for assessing the se-verity and prognosis of patients with severe sepsis .It could be used as a predictor for clinical treatment and provide some guidance .