严重感染及感染性休克患者血清脑钠肽变化及其对心功能预后预测作用.doc

严重感染及感染性休克患者血清脑钠肽变化及其对心功能预后预测作用[摘要] 目的：探讨严重感染及感染性休克患者血清脑钠肽(BNP)变化及其对心功能预后的预测作用。方法：对我院68例严重感染及感染性休克的患者进行前瞻性研究，68例患者进入重症监护病房（ICU）24 h内测动脉血BNP及左心室射血分数（LVEF）。根据患者LVEF水平分为心功能正常组和心功能不全组，比较两组患者BNP水平；患者住院28 d死亡19例作为死亡组，存活49例，作为存活组，回顾性分析两组BNP水平，用ROC曲线评价BNP预测死亡的临界值。结果：①心功能不全组患者BNP水平显著高于心功能正常组患者BNP水平（P691.8 ng/L为预测死亡的临界值，敏感度为91.7%，特异度为80.7%。结论：严重感染及感染性休克患者BNP水平显著升高，BNP对于患者心功能的预后具有一定的预测价值。 [关键词] 感染性休克；血清脑钠肽；左心室射血分数；心功能 [中图分类号] R459.9[文献标识码]Ａ [文章编号]1673-7210（2011）07（c）-163-02 The predictive values of B-type natriuretic peptide for the heart function and prognosis in patients with severe sepsis and septic shock JIN Xin ,WANG Yao Daqing Oil Field General Hospital, Heilongjiang Province, Daqing 163001, China [Abstract] Objective: To study the predictive values of B-type natriuretic peptide for the heart function and prognosis in patients with severe sepsis and septic shock. Methods: 68 patients of severe sepsis and septic shock were prospectively studied, 68 patients into ICU were tested BNP and left ventricular ejection fraction measured arterial blood (LVEF) in 24 h, dividing the patients into the normal heart function and heart failure group according to LVEF, BNP levels were compared between two groups, 19 patients died as the 28 d hospital death group, 49 survived, as the survival group, retrospective analysis of two groups of BNP, BNP predicted by ROC curve analysis threshold of death. Results: ① BNP in patients with heart failure group was significantly higher than normal cardiac function in patients with BNP level group (P 691.8 ng/L was critical value for the prediction of death, the sensitivity was 91.7%, specificity was 80.7% (P38℃或90次/min；③呼吸频率20次/min；④WBC12×109/L或 2 结果 2.1患者观察28 d内的临床特征 入院24 h内根据LVEF水平分为心功能正常组35例，心功能不全组33例；入院28 d根据患者死亡与否分为死亡组19例，存活组49例。 2.2 BNP水平与心功能不全的关系 心功能不全组患者BNP水平显著高于心功能正常组患者BNP水平（P691.8 ng/L为预测死亡的临界值，敏感度为91.7%，特异度为80.7%（P 1