摘要
目的探讨老年脓毒性休克患者血清降钙素原（PCT）、B型钠尿肽（BNP）的变化及其对预后评估的价值。方法按照治疗预后我院重症监护室2013年1月~2015年6月在我院重症监护室收治的脓毒症患者80例,根据治疗后的结果将患者分为复苏成功组（A组）14例,复苏无效或恶化组（B组）48例和死亡组（C组）18例。分别于复苏前及复苏后1周取静脉血行PCT及BNP测定,并比较患者复苏前及复苏后1周内急性生理学与慢性健康状况评分（APACHE II）。结果复苏前三组BNP、APACHE II评分有统计学差异（P〈0.05）,A组最低,C组最高。复苏后1周三组PCT、BNP及APACHE II评分均有统计学差异（P〈0.05）,A组最低,C组最高。与复苏前比较,A组PCT、BNP及APACHE II评分均下降（P〈0.05）;B组、C组PCT、BNP及APACHE II评分均上升（P〈0.05）。Pearson相关性分析表明,PCT（r=0.556,P=0.032）、BNP（r=0.642,P=0.024）,均与APACHE II评分呈统计学相关。结论 PCT及BNP的动态监测对于老年脓毒症性休克的早期诊断、治疗预后具有重要意义,其检测值的持续上升可提示患者预后不良。
Objective To investigate the changes and clinical significance on prognosis of serum level of procalcitonin（PCT） and B type natriuretic peptide（BNP） in elderly patients with septic shock. Methods In accordance with the treatment and prognosis, 80 patients with septic shock in the department of ICU in our hospital from January 2013 to June 2015 were divided into resuscitation group（group A,n=14）, invalid or deteriorated group（group B, n=48） and death group（group C, n=18）. The PCT and BNP from veinal blood before recovery and one week after recovery were measured. And the acute physiology and chronic health status score（APACHE- II） in all groups were also compared. Results The PCT and APACHE II scores before recovery in three groups were significantly different（P〈0.05）, among which, the lowest scores was in group A, and the highest scores was in group C. One week after recovery,there were significantly difference of PCT, BNP and APACHE II in three groups（P〈0.05）, and among which, the lowest value was in group A, and the highest value was in group C. Compared with resuscitation, the PCT, BNP and APACHE II in group A were decreased（P〈0.05）, and which were both increased in group B and group C（P〈0.05）. Pearson correlation analysis showed that PCT（r=0.556,P=0.032）and BNP（r=0.642,P=0.024）both had statistically significant difference with APACHE-II scores. Conclusion Dynamic monitoring of PCT and BNP has important significance on early treatment and diagnosis of elderly patients with septic shock, and continuous increase of the detection value can be suggested the poor prognosis.
出处
《新疆医学》
2016年第3期251-253,257,共4页
Xinjiang Medical Journal
基金
新疆医科大学科研创新基金项目(XJC201366)
关键词
脓毒性休克
降钙素原
B型钠尿肽
诊断
预后
septic shock
calcitonin
B type natriuretic peptide
diagnosis
prognosis
