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目的:研究ICU严重脓毒症患者的脑钠肽(BNP)水平以及与其早期预后的相关性。方法:选择自2013年12月至2015年3月来临海市第二人民医院进行治疗的240例严重脓毒症患者作为观察组,另外选取同期的健康体检者250人作为对照组。患者首先进行急性生理和慢性健康情况评分(APACHE II)、CRP、相关脏器衰竭评价(SOFA)以及在入院以后的第一天和第三天进行血浆BNP值等一系列检测。使用荧光免疫测定法检测其BNP浓度含量,其检测过程由专业的技术人员按照说明书严格操作。结果:观察组中重症脓毒症患者在第一天和第三天的BNP含量水平显著高于对照组,两组相比具有显著的差异,具有统计学意义(P<0.05)。并且重症脓毒症患者的BNP水平随时间增长显著增加,第三天与第一天相比具有统计学意义(P<0.05)。为研究BNP水平对于重度脓毒症患者预后的相关性,30天后对患者存活情况进行随访,将其分成存活组和死亡组。存活组中的APACHE II评分以及SOFA评分均明显低于死亡组,其第一天和第三天的BNP含量以及CRP含量均明显少于死亡组。两组相比具有显著,差异具有统计学意义(P<0.05)。结论:患者的BNP水平对于评估其病情严重程度以及预后相关性具有重要的指导意义,对ICU严重脓毒症患者进行血浆BNP水平检测并进行早期干预,可有效降低患者的病死率,提高治疗效果。
OBJECTIVE: To investigate the level of brain natriuretic peptide (BNP) in patients with severe sepsis in ICU and its correlation with its early prognosis. Methods: Two hundred and seventy-two patients with severe sepsis who were treated in Linhai Second People’s Hospital from December 2013 to March 2015 were selected as the observation group. In the same period, 250 healthy people were selected as the control group. Patients were initially assessed for acute physiologic and chronic health conditions (APACHE II), CRP, associated organ failure assessment (SOFA), and plasma BNP values on the first and third day after admission. The use of fluorescence immunoassay to measure the concentration of BNP, the testing process by the professional technicians in accordance with the instructions of the strict operation. Results: The levels of BNP in severe sepsis patients on the first day and the third day in the observation group were significantly higher than those in the control group. There was a significant difference between the two groups (P <0.05). And BNP levels in patients with severe sepsis increased significantly with time, the third day compared with the first day was statistically significant (P <0.05). To investigate the association of BNP levels with prognosis in patients with severe sepsis, survival of patients was followed up 30 days later and divided into survivors and deaths. APACHE II score and SOFA score in survival group were significantly lower than those in death group. BNP content and CRP content in first day and third day were significantly lower than those in death group. There was significant difference between the two groups (P <0.05). Conclusion: The level of BNP is of great significance in assessing the severity of the disease and the prognosis of patients. Serum BNP levels and early intervention in patients with severe ICU sepsis can effectively reduce the mortality and improve the therapeutic effect .