摘要
目的 探讨全血N末端脑钠肽前体（NT-proBNP）浓度与重度烧伤患者补液量的相关性;评价重度烧伤患者监测NT-proBNP的预警意义。方法 选取2012年9月至2015年9月解放军第100医院烧伤科收治的重度烧伤患者53例,入院前均无重大疾病史、遗传史。其中烧伤面积在35%~50%总体表面积（TBSA）或者Ⅲ度10%~20%TBSA共25例为A组,烧伤总面积〉50%TBSA或Ⅲ度〉20%TBSA共18例为B组,烧伤总面积〉90%且复合爆震伤患者共10例为C组;所有患者入院第1~30天监测NT-proBNP浓度用于指导输血及补液。对照组为53例同期年龄相仿的整形美容患者。与补液量计算公式相比,比较NT-proBNP的指导优势。结果 此次纳入研究的烧伤患者实际补液量均高于通用补液公式计算出的结果,烧伤越严重,NTproBNP浓度越高,血制品需求量越多;C组与B组、B组与A组间进行比较,NT-proBNP浓度、补液量、MAP输注量、血小板输注量差异均有统计学意义（P〈0.05）。结论 NT-proBNP浓度改变对重度烧伤患者中长期合理控制输血输液量可能有较高的指导和预警意义。
Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases（group A） had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases （group B） had the total burn area of 〉50% TBSA or Ⅲ degree 〉20% TBSA for group B and 10 cases（group C） had the total burn area〉90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A （P〈0 .05） .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .
出处
《国际检验医学杂志》
CAS
2016年第16期2226-2228,共3页
International Journal of Laboratory Medicine
基金
南京军区医学科技创新课题(14ZD12)
