The Clinical Significance Of The Blood BNP Level In Spesis

Objective The purpose of this study was to investigate whether the inflammatoryresponse can lead to the increase of the blood BNP level, and to discuss the correlationbetween the BNP level and the lactic acid, to estimate the prognosis value of the BNP level insepsis and septic shock patients.Methods Critically patients in the department of ICU, affiliated hospital of ningxiamedical university, were retrospectively collected as study objects, from January2011toOctober2012. There were31cases from sepsis group,30cases from septic shock group, and37uninfected cases at the same period serving as control group. All data of BNP is dividedinto four groups by PCT <0.5ng/ml PCT:0.5-2ng/ml PCT:2-10ng/ml PCT>10ng/ml,respectively P1, P₂, P₃, P4.All patients detected blood BNP, procalcitonin（PCT）, routinebiochemical, blood gas analysis, routine blood. And assay the score of SOFA. Measurementdata were statistical described by（x±s）. Analyze the clinical data.Results1.There is no difference among groups of sepsis, the group of septic shock andthe control group in age （F=0.356, P=0.702）. And there is no difference among groups ofsepsis, the group of septic shock and the control group in sex（χ2=2.538，P=0.082）.；2.The BNPlevel of sepsis group is higher than that of control group（Z=-4.685, P=0.000）;The BNPlevel of septic shock group is higher than that of control group（Z=-6.324, P=0.000）; TheBNP level of septic shock group is higher than that of sepsis（Z=-2.470, P=0.013）; Thedifference of the total number of white blood cells between the control group and the sepsisgroup was not statistically significant （Z=-1.545, P=0.122）; The total number of whiteblood cells of the septic shock group is higher than that of the control group（Z=-2.695, P=0.009）; The difference of white blood cells between sepsis, septic shock group is not statistically significant （Z=-1.811, P=0.070）; The level of lactic acid of sepsis group ishigher than that of control group（Z=-3.305, P=0.001）; The level of lactic acid of septicshock group group is higher than that of control group is not statistically significant（Z=-5.648, P=0.000）; The difference of lactic acid between sepsis group and septic shockgroup（Z=-3.565, P=0.000）.3. The difference of BNP between P1and P₂group is notstatistically significant（Z=-1.362, P=0.173）; The BNP level of P₃group is higher than that ofP1group（Z=-3.030, P=0.002）；The BNP level of P4group is higher than that of P1group（Z=-6.491, P=0.000）；The difference of BNP between P₂and P₃group is not statisticallysignificant（Z=-1.646, P=0.100）；The BNP level of P4is higher than that of P₂group（Z=-4.113,P=0.000）；The BNP level of P4group is higher than that of P₃group（Z=-5.103, P=0.000）;4There is a linear correlation between the BNP level and the lactic acid,（r=0.395, P=0.000）.;5There is a linear correlation between the BNP level and the score of SOFA,（r=0.549, P=0.000）;6The area under the curve is0.713which was used to evaluated the prognostic valueof the BNP level in patients with sepsis and septic shock. The sensitivity and specific degreesof are66.7%and74.5%when the BNP level is over134.5pg/ml.Conclusion1There is a significantly positive correlation between the BNP level and inflammatoryresponse. Inflammatory response can lead to increase the levels of BNP of the patients. Therewere more severe degree of Inflammatory response and the higher of the BNP level.2The BNP level with the lactate level was linear correlation,And the BNP level with thescore of SOFA was linear correlation.3The BNP level can be used as a routine clinical detection indexes to judge theprognosis of patients with sepsis and septic shock.