广州医科大学学报

目的:探讨监测脑钠肽(BNP)对判断老年感染性休克患者预后的临床意义。方法:回顾性分析78例于2007年6月至2013年10月入住的老年感染性休克患者的临床资料,根据其入科6及24 h BNP水平,分为A组(BNP<100 pg/mL)、B组(100 pg/mL≤BNP<500 pg/mL)和C组(BNP≥500 pg/mL)。比较各组24 h内APACHE II评分、6、24 h血乳酸值,ICU住院时间及患者入ICU后28 d内死亡率。结果:A组和B组APACHEⅡ评分、血乳酸及ICU住院时间,28 d内死亡率比较,差异无统计学意义(P>0.05),与A组、B组比较,C组上述指标均显著升高(P<0.05)。结论:BNP水平对老年感染性休克患者预后的判断有一定意义,BNP水平≥500 pg/mL可能是患者病情加重及死亡率增高的一个重要判断指标。

Objective:To investigate the predictability of brain natriuretic peptide(BNP) on the prognosis in elderly patients with septic shock.Methods:Seventy-eight elderly patients with septic shock recruited between June 2007 and October 2013 in the Intensive Care Unit,Panyu Hexian Memorial Hospital,were retrospectively analyzed.Patients were,according to their BNP levels at 6 and 24 h after admission,allocated to group A(BNP<100pg/mL),group B(100 pg/mL ≤ BNP < 500 pg/mL)and group C(BNP ≥500 pg/mL).The 24-hour APACHE II score,blood lactic acid at 6 and 24 h,length of stay in the intensive care unit and in-hospital mortality within 28 days were compared.Results:There were no significant differences in the APACHE II score,blood lactate,the length of stay in ICU and mortality within 28 days between group A and group B(all P>0.05).Compared with groups A and B,all indices were significantly heightened in group C(all P<0.05).Conclusion:The level of BNP has considerable predictability on the prognosis of elderly patients with septic shock.BNP being500 pg/mL or greater may be an important index of exacerbations and higher mortality.