摘要
目的 :探讨B型利钠肽(B type natriuretic peptide,BNP)对感染性休克患者早期液体复苏容量负荷的预测价值,从而更好地找出反映容量负荷的相关标志物,辅助判断ICU感染性休克患者容量状态。方法:选取入住ICU感染性休克患者60例,给予早期目标导向治疗(early goal-directed therapy,EGDT),利用脉搏指示连续心输出量监测系统记录早期液体复苏前后胸腔内血容量指数(intrathoracic blood volume index,ITBVI)、全心舒张末容积指数(global end diastolic volume index,GEDVI)、血管外肺水指数(extravascular lung water index,EVLWI)等血流动力学指标,并监测相应时间点全血BNP含量,通过与相应血流动力学指标进行相关性分析探讨两者相关性。结果:经过EGDT后,所有患者ITBVI、GEDVI、BNP均有显著升高,EVLWI未见明显升高;60例患者液体复苏0、6 h,BNP含量与对应的ITBVI、GEDVI、EVLWI均无显著相关性。液体复苏前后ΔBNP(前后时间点BNP差值)与对应的ΔITBVI、ΔGEDVI(前后时间点ITBVI、GEDVI差值)存在相关性,与ΔEVLWI(前后时间点EVLWI差值)无相关性。结论:BNP含量对感染性休克患者早期液体复苏容量负荷的评估价值尚不确定。
Objective： To investigate the predictive value of B type natriuretic peptide in evaluating fluid volume in the patients re- ceiving fluid resuscitation with early phase of septic shock, and to find the relative markers of fluid volume which can accurately re- flect the blood volume of septic shock. Methods： A prospective study was performed on 60 patients with septic shock enrolled in the intensive care unit of our hospital. All the patients receiving early goal-directed therapy（EGDT）, the hemodynamic parameters such as intrathoracic blood volume index （ITBVI）, global end diastolic volume index （GEDVI）, extravascular lung mater index （EVLWI） were record by using PICCO system before and after EGDT, and the parameters of BNP were record at the same time. The correlations be- tween changes in BNP and changes in ITBVI,GEDVI and EVLWI were tested by Pearson correlation analysis. Results： ITBVI,GEDVI and BNP in all patients were significantly elevated after EGDT. BNP level was not correlated with ITBVI,GEDVI and EVLWI at the time point 0 h and 6 h in the 60 patients receiving fluid resuscitation. The changes in BNP （ABNP） showed significant correlation with changes in AITBVI and AGEDVI. AEVLWI was not correlated with ABNP. Conclusion： The predictive value of B type natriuretic peptide in evaluating fluid volume in the patients receiving fluid resuscitation with early phase of septic shock is uncertain.
出处
《南京医科大学学报（自然科学版）》
CSCD
北大核心
2017年第11期1433-1436,共4页
Journal of Nanjing Medical University(Natural Sciences)
关键词
BNP
感染性休克
容量负荷
B type natriuretic peptide
septic shock
fluid volume
