重症肺炎致急性呼吸窘迫综合征患者血NT-proBNP、cTnI水平的临床观察及其与炎性反应的相关性研究

发布时间：2018-01-02 22:03

本文关键词：重症肺炎致急性呼吸窘迫综合征患者血NT-proBNP、cTnI水平的临床观察及其与炎性反应的相关性研究　出处：《重庆医学》2015年31期 　论文类型：期刊论文

【摘要】：目的本研究通过观察重症肺炎致急性呼吸窘迫综合征(ARDS)患者血N末端B型钠尿肽前体(NT-proBNP)、肌钙蛋白I(cTnI)水平及其与C-反应蛋白(CRP)之间的关系,从而进一步深入探讨ARDS,尤其是ARDS后继发心肌损伤的病理生理过程及临床意义。方法将确诊为重症肺炎致ARDS的患者33例分为轻度、中度、重度3组,收集患者入院时血气分析、CRP、NT-proBNP、cTnI等相关指标数据,并进行统计学分析。结果重度组NT-proBNP水平明显高于轻、中度组(P0.01),中度组NT-proBNP水平也较轻度组升高(P0.05);重度组cTnI水平与轻、中度组比较明显增高(P0.01),而轻、中度组间比较差异无统计学意义(P0.05);3组间CRP水平也有随着病情加重而逐渐升高,重度组CRP水平显著高于轻度组(P0.05);ARDS患者血NT-proBNP水平与CRP水平呈显著正相关(P0.05),且与cTnI水平呈正相关关系(P0.05)。结论 ARDS病程中过度活化的炎性反应很可能直接参与并介导心肌损伤的病理生理过程;联合NT-proBNP、cTnI检测对ARDS病程早期评价,及早期实施器官功能保护有着重要临床意义。
[Abstract]:Objective to observe the N-terminal natriuretic peptide precursor (NT-proBNPP) in patients with acute respiratory distress syndrome (ARDS) caused by severe pneumonia. The level of cTnI and the relationship between cTnI and C- reactive protein (CRP) were discussed in order to further explore the level of cTnI and the relationship between cTnI and C- reactive protein (CRP). In particular, the pathophysiological process and clinical significance of secondary myocardial injury after ARDS. Methods 33 patients with ARDS caused by severe pneumonia were divided into three groups: mild, moderate and severe. The data of blood gas analysis (CRPT-proBNPcTnI) on admission were collected and analyzed statistically. Results the NT-proBNP level in severe group was significantly higher than that in mild group. The level of NT-proBNP in the moderate group was higher than that in the mild group. The level of cTnI in the severe group was significantly higher than that in the mild group and the moderate group, but there was no significant difference between the mild group and the moderate group. The level of CRP in severe group was higher than that in mild group (P 0.05), and the level of CRP in severe group was higher than that in mild group (P 0.05). There was a significant positive correlation between serum NT-proBNP level and CRP level in patients with ARDS (P 0.05). Conclusion the overactivated inflammatory response in the course of ARDS may be directly involved in and mediate the pathophysiological process of myocardial injury. The combined detection of NT-proBNPN cTnI has important clinical significance for the early evaluation of the course of ARDS and the early implementation of organ function protection.
【作者单位】：广东省佛山市第二人民医院急诊科;
【基金】：佛山市科技局医学类科技攻关项目(201308071)
【分类号】：R563.8
【正文快照】： 急性呼吸窘迫综合征(acute respiratory distress syn-drome,ARDS)是临床的危急重症,病死率高,常合并多器官功能衰竭,尤其是心、肾等靶器官损害。根据近期国内外相关研究显示,心肌损伤标志物N末端B型钠尿肽前体(prohormo neN-terminal probrain natriuretic peptide,NT-proBNP

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