【摘要】 目的探讨在液体复苏中血清B型脑钠肽(B-type natriuretic peptide,BNP)的测定对其成功与否的指导价值。方法研究对象为需要进行液体复苏的26例接受机械通气和镇静的患者,分别于液体复苏前和液体复苏后30 min测定中心静脉压(central venous pressure,CVP),左室射血分数(ejection factor,EF),每搏量(stroke index,SI)和90 min测定血清BNP。分析比较有反应组和无反应组之间差异。以ROC曲线反映BNP和CVP在液体复苏中的预测意义。结果 26例患者分为反应组19例和无反应组7例。有反应组中初始CVP值低于无反应组,差异具有显著性。液体复苏后,两组CVP均较复苏前升高,差异具有显著性。BNP均略有下降,但无显著性意义。ROC曲线中CVP曲线下面积为0.89±0.06,BNP曲线下面积为0.55±0.13。结论 BNP的测定不能作为评价液体复苏成功的指标,CVP可能仍为较准确地反映液体复苏程度的指标。更多还原

【Abstract】 Objective To evaluate the role of plasma BNP concentration in predicting fluid responsiveness.Methods This prospective study included 26 sedated,mechanically ventilated patients requiring cardiac output measurement and fluid challenge.Central venous pressure(CVP),ejection factor(EF),stroke index(SI) and plasma BNP concentration were measured before and after fluid challenge.The difference between two groups was analyzed.Receiver operating characteristic(ROC) curves were generated for BNP and compared to that of CVP that is routinely considered as a marker of cardiac preload.Results Among 26 patients,there were 19 responders and 7 nonresponders.At baseline,CVP in responders was lower than non-responders.After fluid challenge,CVP in two groups were significantly higher than baseline and BNP were slightly lower than baseline but with no significance.The area under the ROC curve for CVP was 0.89 ± 0.06,for BNP 0.55 ± 0.13.Conclusion BNP does not accurately predict fluid responsiveness,but CVP may be the reliable index.更多还原