Characteristics And Clinical Significance Of N-terminal Pro-brain Natriuretic Peptide In Severe Burn Shock Stage

Objective: Through experiments,the characteristics of changes in NT-proBNP levels during severe shock were analyzed.As well as the relationship between fluid intake and NT-proBNP during treatment.To explore the clinical value of the change of NT-proBNP level in severe burn shock period.Methods: Prospective observational studies were used.1.Research objects and groups:(1)Research object: selection of Nankai university affiliated hospital of acute from 2014 to 2016 treated 90 cases of burn patients after(<4h),wound before serious organic disease,and obesity,age 18 to 60 years old.(2)Experimental group: The selected patients were divided into 3 groups according to burn area(30 cases in each group).Group A,TBSA<30% or Ⅲ<10%,age(36 ±18).Group B,TBSA 30%-50% or Ⅲ 10%-20%,age(37±16).Group C,TBSA> 51% or Ⅲ>21%,age(35±17).(3)Control group: Another 30 patients with the same study standard were selected as the control group,age(38±18)years.(4)Comparative A,B,C and control group,gender,and age distribution no significant difference was not statistically significant.(5)Burn patients after admission for early treatment,blood biochemical detection,monitoring of vital signs to understand the patient’s condition changes.2.Sample collection,testing,and method(1)Sample collection: Extraction A,B,C group at admission and after injury 8h,16 h,24h,48 h,72 h of blood.Preoperative venous blood was taken from the control group.(2)Test indexes:(1)The levels of NT-proBNP,cTnI,CK-MB,and LDH were measured in groups A,B,and C and the control group(at admission).(2)The levels of NT-proBNP were measured at 8h,16 h,24h,48 h,and 72 h after injury in A,B,and C groups.(3)The levels of NT-proBNP and cTnI within 72 hours after injury were measured and observed in groups B and C.Analyze their changing characteristics.(4)Record B,C the overall fluid intake level within 72 h after injury.Correlations between fluid resuscitation and NT-proBNP levels were analyzed.(3)NT-proBNP and cTnI were analyzed by enzyme-linked immunofluorescence with a VIDAS analyzer.CK-MB by immunosuppression,of LDH lactate substrate assay,analyzer is AU680.3.Statistical processing: Application SPSS20.0 statistical analysis software to statistical data processing.Measurement data,calculation of average and standard deviation.Between variables: mean±standard deviation.T test was used for comparison between groups.The correlation between NT-proBNP content and fluid intake in severe burn patients was analyzed.P<0.05 was a significant difference between the two groups.Result: 1.In groups A,B and C(at admission),there was no significant difference between CK-MB and LDH and the control group(P>0.05).The serum levels of cTnI and NT-proBNP in group A and group B were not significantly different from those in the control group(P>0.05),while the serum concentration was significantly higher in group C(P<0.05).2.NT-proBNP levels in each group within 72 hours(shock phase),it is found no significant change in A group(P>0.05).The NT-proBNP levels in group B increased slightly from 8h to 24 h after injury(P>0.05),and showed a significant increase from 48 h to 72 h after injury(P<0.05).In group C,NT-proBNP levels increased continuously with time after injury(P<0.05).3.60 cases of patients with severe burns(B,Group C)after injury NT-proBNP concentration in serum continued to increase 72 h.cTnI increased continuously from 8h to 24 h after injury,and peaked at 24 h,which was consistent with the increase trend of NT-proBNP at the same time,but decreased at 48 h.At this time,the trends of cTnI and NT-proBNP showed a "separation" phenomenon.4.60 cases of patients with severe burns(B,Group C)after injury 72 h,serum concentrations of NT-proBNP correlated linearly with the fluid intake period.Conclusion: 1.NT-proBNP can sensitively reflect the changes in cardiac function after severe burn,and suggest that the early presence of cardiac dysfunction in patients with severe burn.2.NT-proBNP has a close relationship with burn area and severity in severe burn patients.3.Early fluid intake in patients with severe burns is positively correlated with NT-proBNP levels and can be used to guide fluid resuscitation during burn shock.