B型尿钠肽前体N末端对全身性感染患者预后评价价值

探讨B型尿钠肽前体N末端（NT—proBNP）在全身性感染患者预后评价方面的价值，及其与APACHEII评分在全身性感染患者的相关性。选取全身性感染患者32例，以28天随访结果，根据其转归分为存活组24例和死亡组8例。分别在确诊后Oh、72h采血行NT—proBNP检测，并采集数据进行APACHEII评分。结果显示死亡组NT—proBNP（Oh）[（5463．7±4152．3）ng／L]明显高于存活组[（839．4±1132．0）ng／L]（P=0．016），72h后死亡组NT—proBNP[（5676．1±3937．4）ng／L]依然高于存活组[（843．5±866．3）ng／L]（P=0．017）。NT—proBNP（Oh）、NT—proBNP（72h）（P〈0．05）是病死率的独立影响因素。经过对数转换的NT—proBNP（Oh）与APACHEⅡ评分明显相关（r=0．73，P〈0．001）。由此可见，NT—proBNP与病死率及APACHEⅡ评分呈显著正相关关系，可以作为一种常规临床检测指标来判断全身性感染患者的预后。

Prognostic Value of Nt -- Probnp in Septic Patients

To investigate prognostic value of N--terminal pro--B--type natriuretic peptide （NT-proBNP）, to investigate the correlation between NT--proBNP level and APACHEII score in septic patients. 32 septic patients were divided into two groups according to survival status in 28 days follow up. 24 patients were in the survivors group, and 8 patients were in the non-survivors group. The blood tests for NT--proBNP analyses were done on the day of admission and 72 hrs thereafter. Patients＇ demographic data for APACHEII score were collected. NT--proBNP levels on admission were significantly higher in non-survivors group [（5 463.7±4 152.3）ng/L] compared with survivors group [ （839.4 ± 1 132.0）ng/L, P= 0. 016]. 72 hrs later, NT--proBNP levels in non-survivors group [（5 676.1±3 937.4）ng/L] remained higher than survivors group [（843.5±866.3）ng/L,P=0. 017]. NT-- proBNP values on admission and 72 hrs after were independent predictors of mortality （P〈0.05 ）. NT--proBNP level （Oh） which had been common logarithm transformed significantly correlated with APACHEII score （ r=0. 73, P〈0. 001）. Therefore, NT--proBNP level correlated positively with the mortality and APACHEII score. It could be a routine clinical biomarker to evaluate prognosis of septic patients.