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目的探讨脓毒症患者降钙素原(PCT)、N端前体B型利钠肽(NT-pro-BNP)水平与急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的相关性。方法选取2014年1月至2016年9月收治的122例脓毒症患者为研究对象,入院24 h内行APACHEⅡ评分及测定血浆PCT、NT-pro-BNP,患者依据APACHEⅡ评分分为A(低危,38例)、B(中危,48例)、C(高危,36例)三组,依据治疗结果分为好转组(86例)和恶化组(36例),选取同期40例非脓毒症患者为对照,比较PCT、NT-pro-BNP在不同APACHEⅡ评分组、不同治疗结果组的差异,分析脓毒症患者PCT、NT-pro-BNP水平与APACHEⅡ评分相关性。结果 APACHEⅡ评分、PCT及NT-pro-BNP水平在脓毒症组高于非脓毒症组(P均<0.01),血浆PCT、NT-pro-BNP水平C组>B组>A组(P均<0.05),恶化组治疗后不同时点APACHEⅡ评分、PCT及NT-pro-BNP水平均高于好转组(P均<0.05),好转组APACHEⅡ评分、PCT及NT-pro-BNP水平依治疗后第1天→第3天→第7天之序递降(P均<0.05);脓毒症患者PCT、NT-pro-BNP水平分别与APACHEⅡ评分呈正相关(r=0.806、0.732,P均<0.05)。结论脓毒症患者PCT、NT-pro-BNP水平与APACHEⅡ评分相关,PCT、NT-pro-BNP水平可在一定程度上反映脓毒症患者病情严重程度。
Objective To investigate the correlation between the levels of procalcitonin (PCT), N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and acute physiology and chronic health status score system Ⅱ (APACHEⅡ) in patients with sepsis. Methods A total of 122 patients with sepsis were enrolled from January 2014 to September 2016. APACHEⅡscores and plasma PCT and NT-pro-BNP were determined within 24 hours after admission. Patients were divided into A (low risk , 38 cases), B (intermediate risk, 48 cases) and C (high risk, 36 cases). According to the results of treatment, the patients were divided into improvement group (86 cases) and exacerbation group (36 cases) To compare the difference of PCT, NT-pro-BNP in different APACHEⅡscore group and different treatment group, the correlation between PCT, NT-pro-BNP level and APACHEⅡscore in septic patients was analyzed. Results The levels of APACHEⅡ, PCT and NT-pro-BNP in sepsis group were significantly higher than those in non-sepsis group (all P <0.01). The levels of PCT, NT-pro-BNP in plasma were higher in group C than in group B (P <0.05). APACHEⅡscore, PCT and NT-pro-BNP levels in the worsened group were higher than those in the reformed group (P <0.05), APACHEⅡscore, PCT and NT-pro- The levels of PCT and NT-pro-BNP in patients with sepsis were positively correlated with APACHEⅡscore (r = 0.806,0.732, P < 0.05). Conclusion The levels of PCT and NT-pro-BNP in patients with sepsis are correlated with APACHEⅡscore. The levels of PCT and NT-pro-BNP may reflect the severity of sepsis to a certain extent.