摘要
目的探讨人心型脂肪酸结合蛋白(H-FABP)与脓毒症患者病情进展及预后的相关性。方法选择自2012年6月至2014年3月接受治疗的76例脓毒症患者,作为观察组;选取30例无脓毒症表现的患者,作为对照组。检测两组患者H-FABP、肌钙蛋白I(cTnI)和B型脑钠肽(BNP),并利用急性生理学及慢性健康APACHE Ⅱ对患者进行评分。所有脓毒症患者在确诊后第1天、第5天、第9天抽血化验计算APACHE Ⅱ评分。根据患者转归将患者分为生存组60例、死亡组16例(2例于入院72 h内死亡,14例于入院9 d后死亡)。对比治疗期间生存组与死亡组各生物标记指标的动态变化。结果脓毒症组H-FABP明显高于对照组,BNP、cTnI和APACHEⅡ评分也明显高于对照组(P<0.05);生存组治疗第9天与第1天和第5天相比,H-FABP、APACHE Ⅱ评分均明显下降(P<0.05),而死亡组第9天与第1天和第5天的H-FABP、APACHE Ⅱ评分相比明显上升(P<0.05);同时发现,在第5天死亡组的H-FABP指标上升最为明显,而BNP和cTnI在该时期无法有效地区分死亡组和生存组。结论 H-FABP可以反映脓毒症患者病情进展,并在一定程度上反映疾病的预后,其在疾病早期的敏感度高于BNP和cTnI。
Objective To evaluate the correlation of human heart - type fatty acid - binding protein （ H - FABP） with progression and prognosis of patients with sepsis. Methods Seventy - six patients with sepsis during June 2012 to March 2014 were selected as observation group objects, while 30 patients without sepsis as control group objects. The H - FABP, cardiac Troponin I （cTnI） and Natriuretic peptides B（BNP） levels were observed for all patients, with Acute Physiology and Chronic Health Evaluation Ⅱ （APACHEⅡ） evaluated. Blood samples of the patients with sepsis were monitored to evaluate APACHE Ⅱ scores at day 1 , day 5 and day 9 after diagnosis, and the patients were sorted into survival group （60 patients） and death group （16 patients： 2 died at day 2 and 14 died after day 9） according to the outcomes. Results The H - FABP level for sepsis patients was significantly greater than that of control group, so were the BNP and cTnl levels and APACHEⅡ scores （ P 〈 0. 05 ）. The H - FABP level and APACHEⅡ score for survival group were reduced significantly in day 9 compared with those measured in day 1 and 5 （ P 〈 0. 05 ）. H - FABP levels and APACHEⅡ scores for death group were greatly increased in day 9 compared with those measured in day 1 and 5 （ P 〈0. 05）. In the other hand, in day 5 the greatest index rise for death group was observed in H - FABP level, while neither BNP nor cTnI can efficiently discriminate between survival group and death group at this stage. Conclusion H - FABP can be used in monitoring disease progress and prognosis for sepsis patients with higher sensitivity in early stage than BNP and cTnI.
出处
《临床和实验医学杂志》
2016年第19期1886-1889,共4页
Journal of Clinical and Experimental Medicine
基金
普陀人民医院青年基金(编号:RYK11-01院级项目)
