摘要
目的探讨早期脑利钠肽（BNP）测定对老年肺部感染性休克患者预后的运用价值，以提高救治成功率。方法将收治的100例年龄61？89岁老年肺部感染性休克患者作为研究对象，根据其人重症监护病房24 h内BNP含量分为八组（〈 200 pg/ml）、B组（200-400 pg/ml）、C组（〉400 pg/ml），对3组患者进行肿瘤坏死因子（TNF-a）以及白细胞介素-8（lL-8）水平、APACHEII评分、升压药物使用时间、机械通气时间、重症监护病房住院时间及28 d病死率进行比较。结果 A组患者在人重症监护病房24 h及治疗后7 d其TNF-α及IL-8水平分别为（13.4±5.4）、（8.4±2.4）ng/L、（132.8±54.3）、（76. 2±23. 1） ng/L，B 组分别为（21.8±9. 8）,（16. 3±3. 8）ng/L、（211.3±43. 2）、（132. 4±34. 5）ng/L,C 组分别为（26. 8± 8. 7）、（19. 5 ±4. 2） ng/L 及（257. 7 ±65. 3）、（183.6±31.9）ng/L，3组比较差异有统计学意义（P〈0. 05）;3组患者在APACHE II评分、升压药物使用时间、机械通气时间ICU住院时间差异有统计学意义；28 d的病死率A组及B组患者分别为10. 00%及15. 63%,差异无统计学意义，28 d内生存率A、B、C组分别为90. 00% ,84. 37%,44. 74%，A、B组与C组在比较，差异有统计学意义（P〈0.05）。结论早期脑利钠肽测定可对老年肺部感染性休克患者预后进行评估，当其〉400 pg/ml是导致患者死亡的危险因素。
OBJECTIVE To evaluate the value of BNP determination at early stage in assessment of the prognosis ofsenile patients with septic shock in lungs,so as to enhance the success rate of treatment. METHODS Totally 100elderly patients with septic shock in lungs aged between 61 and 89 years old were divided into three groups accord-ing to the BNP content within 24 h after entering the ICUs： group A （BNP〈C200 pg / ml）,group B（BNP：200-400 pg/ml）and group C （BNP more than 400 pg/ml）. The levels of TNF-a and IL-8〉 APACHE II score, time ofusing vasopressor drugs,duration of mechanical ventilation, length of stay in ICU and 28 d mortality of the threegroups of patients were compared. RESULTS The TNF-a level and IL-8 level of the in group A 24 h after enteringICU and 7 days after treatment were （13.4 ± 5.4）,（8. 4±2. 4） ng/L and （132, 8 ± 54. 3） , （76. 2 ± 23. 1） respectively; those of the group B were （21. 8±9. 8）,（ 16. 3 ± 3. 8） ng/L and （211. 3 ± 43, 2） , （132. 4± 34. 5） respectively,and those of the group C were （26. 8± 8. 7）,（19. 5 ± 4. 2） ng/L and （257. 7 ± 65. 3）,and （183. 6 ± 31. 9） ng/L,respectively, TNF-α level or IL-8 level among the three groups was statistically significant （P 〈C0. 05） ; theAPACHE n score,time of use of vasopressor drugs, duration of mechanical ventilation, or length of stay in ICUamong the three groups was statistically significant. The 28-day mortality was 10. 00% in the group A,15. 63% in the group B, without statistically significant, the 28-day suvival rate was 90. 00% in the group A,84. 37% inthe group B, 44. 74% in the group C, with statistical difference between the group A,group B, and group C（P〈0. 05）. CONCLUSION The BNP determination at early stage can be used for evaluation of prognosis of elderly patients with septic shock in lungs. BNP more than 400 pg/ml is a risk factor for death.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4333-4335,共3页
Chinese Journal of Nosocomiology
