Predictive Value Of Amino-terminal Brain Natriuretic Peptide Precursors In Children With PICU

Objective: To prospectively study the predictive value of serum amino-terminal brain natriuretic peptide precursor(NT-proBNP)in children with PICU.Methods: 375 hospitalized children with PICU were divided into non-critical group(127 cases),critical group(150 cases)and critical group(98cases)according to PCIS score.The patients were divided into non-sepsis group(284 cases)and sepsis group(91 cases)according to whether they were sepsis or not.The patients were divided into survival group(333 cases)and death group(42 cases)according to the 28-day prognosis.Hospital was detected in serum level of NT-proBNP in 1 days,at the same time record the WBC,CRP and PCT in the first day of the worst value,calculate the PCIS score,FOSA score,PRISM ? score worst values and the number of MODS,record the days of PICU staying,the time of mechanical ventilation and the prognosis of 28 days.Results: The level of serum nt-probnp in critical group was significantly higher than that in critical group and non-critical group,and the level of serum nt-probnp in critical group was significantly higher than that in non-critical group(P<0.05).The mortality of critically ill group was significantly higher than that of critically ill group and non-critically ill group(P<0.01),but therewas no statistical significance between critically ill group and non-critically ill group.Except WBC,serum nt-probnp level,CRP,PCT and FOSA score in the sepsis group were significantly higher than those in the non-sepsis group(P<0.01).The serum NT-proBNP level,mechanical ventilation time,SOFA score,PRISM ? score and the number of MODS in the death group were significantly higher than those in the survival group,while the PCIS score was significantly lower than that in the survival group(P < 0.01).Correlation analysis: except WBC,serum NT-proBNP level was positively correlated with CRP,PCT,mechanical ventilation time,SOFA score,PRISM ? score,MODS number,and negatively correlated with PCIS score(P < 0.05).Logistic regression analysis: high SOFA score was a risk factor for death in children with PICU at 28 days(P=0.005).Conclusions: 1.Serum nt-probnp is related to the severity of the disease in children,and high level of serum NT-proBNP suggests that the illness of the children is more serious.2.Serum nt-probnp level was correlated with the risk of sepsis in children with PICU,and positively correlated with CRP,PCT and SOFA score.3.The level of serum nt-probnp is of certain value in predicting the prognosis.