血浆氨基末端B型脑钠肽前体动态测定对感染性休克患者的预后评估

目的：讨论血浆 NT-proBNP 的动态变化在感染性休克患者预后评估价值。方法采用前瞻性观察研究方法，收集32例感染性休克患者的血浆 NT-proBNP 指标纳入研究。入选患者于入住重症监护室第0、1、3天测定血浆 NT-proBNP 水平。△NT-proBNP1以及△NT-proBNP3、△NT-proBNP3-1被定义为第1天、第3天分别与第0天比较血浆 NT-proBNP 水平变化值以及第3天与第1天比较血浆 NT-proBNP 水平的变化值。根据住院28d 死亡情况在死亡组与生存组之间比较。ROC 曲线下面积比较评价△NT-proBNP1、△NT-proBNP3、△NT-proBNP3-1、NT-proBNP0、NT-proBNP1、NT-proBNP3及 APACHEⅡ在感染性休克患者的病死率的预测价值。结果 ROC 曲线分析显示△NT-proB-NP3是感染性休克患者病死率预测的可靠指标。结论血浆 NT-proBNP 动态测定可能成为感染性休克患者预后评估的更有效的手段。

Prognosis evaluation of dynamic changes of plasmic NT-pro BNP concentration in patients with septic shock

Objective To investigate the prognostic value of dynamic changes of plasmic NT-proBNP concentration in patients with septic shock. Methods A prospective observational study was conducted to collect 32 patients with septic shock, the plasmic NT-proBNP of whom were tested. NT-proBNP plasma levels of included patients were tested in the time points of day 0,day 1st and day 3rd during their intensive care unit stay. △ NT-proBNP1 and △ NT-proBNP3 were defined as plasmic NT-proBNP difference value of day 1,day 3 with day 0 respectively,meanwhile △ NT-proBNP 3-1 was defined as the plasmic NT-proBNP difference value between day 3rd and day 1st. They were compared between death and survival group according to the mortality of hospitalization day 28th. ROC curve of △ NT-proBNP1,△ NT-proBNP3,△ NT-proBNP3-1,NT-proBNP0, NT-proBNP1,NT-proBNP3 and APACHE Ⅱwere compared to assess the predictive value of mortality in septic shock patients. Results ROC curve analysis showed that △ NT-proBNP3 was a reliable indicator of mortality in patients with septic shock. Conclusion Plasma NT-proBNP dynamic measurement may become a more effective means for the evaluation of the prognosis of patients with septic shock.