脓毒症患儿血浆脑钠肽浓度测定的临床意义

目的探讨血浆脑钠肽（BNP）浓度高低在小儿脓毒症临床分级及预后中的临床意义。方法58例脓毒症患儿分为轻症组19例及重症组39例，根据治疗结果分为存活组49例及死亡组9例，在入院后的第1天、第3天、第5～7天应用双向侧流免疫法测定其血浆BNP浓度。结果重症脓毒症患儿各时间点血浆BNP浓度均高于轻症患儿，差异有统计学意义（P〈0．05）；死亡组各时间点血浆BNP浓度均高于存活组，差异有统计学意义（P〈0．01）；存活组血浆BNP浓度第5～7天低于第1天，差异有统计学意义（P〈0．01），而死亡组血浆BNP浓度第5～7天高于第1天，但差异无统计学意义（P〉0．05）。结论血浆BNP浓度的高低，尤其是其动态变化对脓毒症患儿的严重程度及预后具有一定的临床指导意义。

Clinical Significance of Plasma B-type Natriuretic Peptide for Children with Sepsis

Objective To investigate the evaluate of the levels of plasma B-type natriuretic peptide （BNP） of children with sepsis in prognosis and risk stratification significance in sepsis. Methods The study patients consisted of 58 children with sepsis,including 19 children with light sepsis and 39 children with severe sepsis or sptic shock. According to therapeutic outcome,we divided 58 children with sepsis into survivors group and nonsurvivors group. Bi-directional lateral flow immunoassay was used to detect plasma BNP of all the children in the first day,the third day and the fifth to seventh day. Results The levels of plasma BNP in children with severe sepsis or septic shock were higher than those in the children with light sepsis（P〈0.05）;The levels of plasma BNP in the nonsurvivors group were higher than those in the survivors （P〈0.01）;The levels of plasma BNP in the survivors group were decrease in the first day,the third day and the fifth to seventh day （P〈0.01）,but the nonsurvivors group were not. Conclusion The level of plasma BNP is positively correlated with the severity and prognosis of children sepsis ,especially dynamic change.