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目的:探讨脓毒症患者降钙素原(PCT)、脑钠肽(BNP)水平变化及其与预后的关系。方法:选取2012年3月至2014年10月中山市黄圃人民医院收治的92例脓毒症患者的临床资料,根据是否伴有休克分为脓毒症组(n=49)和脓毒性休克组(n=43),检测患者入院后1、3、5 d血浆PCT、BNP水平,进行急性生理学及慢性健康评估(APACHEⅡ)评分,同时测定动脉血乳酸(Lac)、血小板(PLT)水平;另选取同期20例健康体检者作为对照组。结果:脓毒性休克组入院后1、3、5 d PCT水平和BNP水平均明显高于脓毒症组(P<0.01);脓毒症组第5天PCT、BNP水平较第3天下降(P<0.05),脓毒性休克组第3、5天PCT、BNP水平较第1天上升(P<0.05)。血浆PCT水平与BNP水平呈正相关关系(P<0.01),血浆PCT、BNP水平与Lac水平及APACHEⅡ评分呈正相关关系(P<0.05),而与PLT水平呈负相关(P<0.05)。脓毒性休克组患者28 d病死率明显高于脓毒症组患者(58.14%比45.65%,P<0.05)结论:PCT、BNP有助于预测脓毒症患者的预后,PCT、BNP水平升高提示预后不良。
Objective: To investigate the changes of procalcitonin (PCT) and brain natriuretic peptide (BNP) in patients with sepsis and its relationship with prognosis. Methods: The clinical data of 92 patients with sepsis admitted to Zhongshan Huangpu People’s Hospital from March 2012 to October 2014 were selected according to whether they were divided into sepsis group (n = 49) and septic shock (N = 43). Plasma PCT and BNP levels were measured at 1, 3 and 5 days after admission. The acute physiology and chronic health evaluation (APACHEⅡ) scores were also measured. The levels of lactic acid (Lac) and platelet (PLT) Another 20 healthy subjects were selected as the control group. Results: The levels of PCT and BNP in the septic shock group were significantly higher than those in the sepsis group on the 1st, 3rd and 5th days after admission (P <0.01). The levels of PCT and BNP in the septic shock group decreased on the 5th day P <0.05). The levels of PCT and BNP in septic shock group increased on the first and third days (P <0.05). There was a positive correlation between plasma PCT level and BNP level (P <0.01). Plasma PCT, BNP levels were positively correlated with Lac level and APACHEⅡscore (P <0.05), but negatively correlated with PLT level (P <0.05). The 28-day mortality rate in septic shock group was significantly higher than that in sepsis group (58.14% vs 45.65%, P <0.05). Conclusion: PCT and BNP can be used to predict the prognosis of patients with sepsis and increase the levels of PCT and BNP Prompted poor prognosis.