[The relationship between the level of N-terminal pro-B-type natriuretic peptide and prognosis in patients with sepsis].

Jian Liu, Hong-xia Wang, Kun Men
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Abstract

Objective: To detect the relationship between the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and prognosis in patients with sepsis.

Methods: A prospective controlled study was conducted. Sixty cases, including 39 sepsis and 21 severe sepsis, were enrolled from May 2010 to October 2011 in intensive care unit (ICU) of Second Hospital of Tianjin Medical University. The serum level of NT-proBNP was determined and acute physiology and chronic health evaluation II (APACHEII) score was calculated on the 1st and 3rd day. The receiver operator characteristic curve (ROC curve) was draw. According to the 28-day prognosis, all patients were divided into the survival group (n=42) or the death group (n=18). At the same time 30 healthy people were enrolled as control group.

Results: The level of NT-proBNP in the sepsis patients on the 1st and 3rd day were significantly higher than those of healthy controls (65.77±34.78 ng/L, 74.23±42.12 ng/L vs. 48.36±35.53 ng/L, P<0.05 and P<0.01). The level on 1st day of the severe sepsis group was higher than sepsis group (71.69±32.86 ng/L vs. 50.11±36. 98 ng/L, P<0.05), but there was no statistically significance on the 3rd day. The level of NT-proBNP in death group was increased gradually and significantly higher than that of survival group on the 3rd days (99.20±44.34 ng/L vs. 66.79±39.28 ng/L, P<0.05), but no difference was found on the 1st day. The APACHEII score of severe sepsis group were much higher than those of sepsis group on the 1st and 3rd day (1st day:23.92±7.57 vs. 14.87±6.50, 3rd day:19.28±8.80 vs. 10.43±7.27, both P<0.01). The APACHEII score of death group were also much higher than those of survival group on the 1st and 3rd day (1st day:26.71±6.72 vs. 18.83±7.84, 3rd day:31.11±5.06 vs. 13.80±7.27, both P<0.01). The cut point for the evaluation of sepsis prognosis were NT-proBNP≥63.5 ng/L and APACHEII score≥20, which sensitivity were 65.4% and 88.5%, and specificity were 62.5% and 69.4% respectively.

Conclusion: Serum NT-proBNP levels elevation imply the poor prognosis in patients with sepsis.

脓毒症患者n端前b型利钠肽水平与预后的关系。
目的:探讨脓毒症患者n端前b型利钠肽(NT-proBNP)水平与预后的关系。方法:采用前瞻性对照研究。选取2010年5月至2011年10月在天津医科大学第二医院重症监护室(ICU)收治的60例患者,其中脓毒症39例,严重脓毒症21例。测定血清NT-proBNP水平,并于第1天和第3天计算急性生理和慢性健康评估II (APACHEII)评分。绘制受试者操作者特征曲线(ROC曲线)。根据28天预后将所有患者分为生存组(n=42)和死亡组(n=18)。同时选取30名健康人作为对照组。结果:脓毒症患者血清NT-proBNP水平在第1、3天显著高于健康对照组(65.77±34.78 ng/L, 74.23±42.12 ng/L vs 48.36±35.53 ng/L)。结论:血清NT-proBNP水平升高提示脓毒症患者预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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