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目的探讨分析氨基末端脑钠肽前体(NT-proBNP)水平对感染性休克患者心功能的评估价值,为临床感染性休克患者的心功能评价提供有效地科学参考依据。方法选取2011年3日-2014年2月47例感染性休克患者被分为死亡组与存活组,并在患者进入ICU后根据心功能的动态变化将其分为心功能正常组与心功能不全组,比较两组患者的临床资料及进入ICU后不同时间点NT-proBNP的水平与患者心功能的相关性。结果进入ICU第1、2、3天,存活组患者血浆NT-proBNP的水平明显低于死亡组患者,差异有统计学意义(t=28.242、26.058、30.287,P<0.01);NT-proBNP水平在第1天与患者的体质指数呈负相关(P<0.05),在第3天与患者的体质量指数、左室多普勒E/A值呈负相关(P<0.05),在第7天与左室多普勒E/A值、左室射血分数、组织多普勒成像下二尖瓣口血流频谱收缩期峰值、组织多普勒成像下二尖瓣环侧壁峰值运动速度e/a比率呈负相关(P<0.05),而与左心Tei指数呈正相关(P<0.05);入住ICU第7天,心功能正常组脑钠肽(BNP)的水平要明显低于心功能不正常组(t=6.542 P<0.01)。结论感染性休克患者发病1周后,其血浆脑钠肽对于左心室功能受损有着一定的提示作用,但在临床中应结合其他检查依据。
Objective To explore the value of analyzing the NT-proBNP level in the evaluation of cardiac function in patients with septic shock, and to provide an effective scientific reference for the evaluation of cardiac function in patients with septic shock. Methods Seventy-three patients with septic shock were divided into death group and survival group from March 2011 to February 2014. Patients were divided into two groups according to the dynamic changes of cardiac function: normal heart function group and cardiac insufficiency The clinical data of two groups were compared and the correlation between the level of NT-proBNP and cardiac function at different time points after entering the ICU was analyzed. Results The levels of plasma NT-proBNP in survival group were significantly lower than those in death group on the first and second day after ICU admission (t = 28.242,26.058,30.287, P <0.01); NT-proBNP level (P <0.05) on day 1, negative correlation with body mass index and left ventricular Doppler E / A on day 3 (P <0.05), and on day 7 Day and left ventricular Doppler E / A value, left ventricular ejection fraction, tissue mitochondria peak mitral flow peak systolic velocity, mitral annular wall velocity under tissue Doppler imaging e / a ratio (P <0.05), but positively correlated with left ventricular Tei index (P <0.05). On the seventh day after ICU admission, the level of BNP in normal heart function group was significantly lower than that in heart Abnormal function (t = 6.542 P <0.01). Conclusions After one week of onset of septic shock, its plasma brain natriuretic peptide (BNP) may be a useful indicator of left ventricular dysfunction. However, other tests should be used in clinical practice.