【摘要】 目的探讨B型钠尿肽前体(pro-BNP)与非心源性危重症患儿预后的关系。方法选取50例非心源性危重症患儿,根据入院后96 h内血清pro-BNP水平分为研究组27例(pro-BNP>300 pg/ml)、对照组23例(pro-BNP≤300 pg/ml)。比较两组患儿治疗前后的急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)得分,ICU入住时间,总住院时间,住院费用,发生多器官功能障碍综合征(MODS)时衰竭器官数目、机械通气使用率、住院期间和6个月随访期间的死亡情况。结果治疗后两组的APACHEⅡ评分均降低(P <0. 05),但研究组APACHEⅡ评分仍高于对照组(P <0. 05)。研究组ICU入院时间和总住院时间均长于对照组,住院费用多于对照组,MODS发生时衰竭器官数、机械通气率均高于对照组(均P <0. 05)。两组住院病死率及6个月随访期间死亡者比例比较,差异无统计学意义(P> 0. 05)。结论对于非心源性危重症患儿,血清pro-BNP水平越高预后可能越差,pro-BNP在预后评估中有一定的价值。更多还原

【Abstract】 Objective To investigate the relationship between pro-B-type natriuretic peptide( pro-BNP) and prognosis in the children with non-cardiac critical illness. Methods Fifty children with non-cardiac critical illness were enrolled. The children were divided into study group( n = 27,pro-BNP > 300 pg/ml) and control group( n = 23,pro-BNP≤300 pg/ml) according to their pro-BNP levels within96 hours after admission. The indices of the children were compared between the two groups,including the scores of Acute Physiology And Chronic Health EvaluationⅡ( APACHEⅡ) before and after treatment,ICU stay,total hospital stay,hospitalization costs,the number of organs with dysfunction when multiple organ dysfunction syndrome( MODS) occurred,the mechanical ventilation rate,the death rate during hospitalization and the 6-month of follow-up. Results After treatment,the APACHEⅡ scores of both groups decreased( P < 0. 05),but the APACHEⅡscore of the study group was still higher than that of the control group( P < 0. 05). Compared to the control group,the study group had longer ICU stay and total hospital stay,more hospitalization costs,more organs with dysfunction when MODS occurred,and higher mechanical ventilation rate( all P < 0. 05). There was no statistically significant difference in the death rate during hospitalization or proportion of deaths occurred in the 6-month of follow-up( P > 0. 05). Conclusion For the children with non-cardiac critical illness,the prognosis is probably more poorer when the serum pro-BNP level is higher,and pro-BNP is valuable for prognosis evaluation in a certain degree.更多还原