摘要
目的:探讨急性生理与慢性健康状况(APACHEⅡ)评分联合血清N末端脑钠肽前体(NT-proBNP)、降钙素原(PCT)水平检测在ICU脓毒血症患者预后评估中的应用价值。方法:选取92例ICU脓毒血症患者作为观察组,观察组依据病情严重程度分为观察A组(脓毒血症休克)31例、观察B组(严重脓毒血症)31例及观察C组(一般脓毒血症)30例,另取30例同期健康体检者作为对照组,均行血清NT-proBNP、PCT水平检测,并进行APACHEⅡ评分评估,观察比较各组APACHEⅡ评分及血清NT-proBNP、PCT水平,并分析观察组治疗后不同生存状况下APACHEⅡ评分及血清PCT、NT-proBNP水平。结果:观察组各组血清NT-proBNP、PCT水平均高于对照组,观察A组血清NT-proBNP、PCT水平及APACHEⅡ评分高于观察B组及观察C组,观察B组血清NT-proBNP、PCT水平及APACHEⅡ评分高于观察C组(P<0.05);治疗1个月后该病病死率为10.87%(10/92),死亡组血清NT-proBNP、PCT水平及APACHEⅡ评分均高于存活组(P<0.05)。结论:ICU脓毒血症患者血清NT-proBNP、PCT水平高于健康者;包括APACHEⅡ评分在内,各指标随病情加重而升高,死亡者较存活者高,可作为脓毒血症病情分级及预后评估的有效指标。
Objective： To investigate the application value of acute physiology and chronic health status（ APACHEⅡ） score combined with serum N-terminal pro-brain natriuretic peptide（ NT-proBNP） and procalcitonin（ PCT） levels in the prognosis evaluation of patients with ICU sepsis. Methods： 92 cases of ICU sepsis were selected as the observation group. According to the severity of the disease,they were divided into observation group A（ septic shock）,observation group B（ severe sepsis） and observation group C（ general sepsis）,with 30 cases in each group. In addition,30 healthy subjects were enrolled as the control group. Serum NT-proBNP and PCT levels were detected in each group and APACHEⅡ rating was assessed. The APACHEⅡ score and serum NT-proBNP and PCT levels were observed and compared before treatment and under different living conditions after treatment. Results： In the observation group,the serum NT-proBNP and PCT levels were higher than those of the control group; serum NT-proBNP,PCT level and APACHEⅡ score of the observation group A were higher than those of the observed group B and C; and the serum NT-proBNP,PCT level and APACHEⅡ score of the observation group B were higher than those of the observation group C（ P〈0.05）. After 1 month of treatment,the fatality rate was 10. 87 %（ 10/92）. The serum levels of NT-proBNP,PCT and APACHEⅡ in the death group were higher than those in the survival group（ P〈0. 05）. Conclusion： The APACHEII score,serum NT-proBNP and PCT levels in patients with ICU sepsis were higher than those of the healthy subjects and the amount of dead patients was higher than survivors,which could be used as an effective index for severity grading and evaluating the prognosis of sepsis.
作者
杨燕
栗延伟
YANG Yan;LI Yanwei(Xinxiang Central Hospital,Xinxiang 453000,China;The Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000)
出处
《包头医学院学报》
CAS
2018年第5期26-27,42,共3页
Journal of Baotou Medical College
