Prognosis evaluation of BNP combined with Ee'in patients with sepsis-induced myocardial dysfunction

TANG Zhong-xiang; ZHANG Yan-hua; HUANG Hui-ping; ZHU Zhi-yong; CHEN Hai-min; LI Feng-hui; WANG Ying-jing; PENG Zhi-yun; LIN Hui-wen; ZENG Zhao-shang; LIU Wei-feng; PENG Huan-qing

摘要：Background Sepsis-induced myocardial dysfunction is a common complication and the main cause of mortality in patients with sepsis.At present,there is still lack of specific early diagnosis index of the disease.Our study was aimed to investigate the diagnosis and prognosis evaluation value of b-type natriuretic peptide (BNP) combined with the ratio of early diastolic transmitral inflow velocity (E) to early diastolic mitral annulus velocity (e') (Ee') in sepsis-induced myocardial dysfunction,so as to apply them as early warning indicators of the disease.Methods Sixty-six cases of patients with sepsis were selected and divided into disorder group (myocardial dysfunction,n=28) and normal group (normal myocardial function,n=38).Ee'of patients at the same time of LVEF detection,plasma BNP levels and APACHE Ⅱ score and the 28 d survival rate of the two groups were also determined and compared.The correlations of between plasma BNP levels and Ee'in sepsis patients with myocardial dysfunction with LVEF,APACHE Ⅱ score and 28 d survival rate were analyzed,and the value of them in combination for predicting the 28 d survival rate was analyzed.Results Compared with the normal group,Plasm(a) BNP levels,Ee'and APACHE Ⅱ scores in the disorder group were increased (P ＜ 0.05).The 28 d survival rate of the patients in the disorder group was lower than that in the normal group (42.68％ vs.73.68％;P ＜ 0.05).Compared with the survival patients in the disorder group,plasma BNP levels,Ee'and APACHE l scores of the dead patients in disorder group were higher,while LVEF in the dead patient in disorder group was lower (P ＜ 0.05).Spearman unconditional correlation analysis and Logistic multiple regression analysis model results showed that plasma BNP levels and Ee'in sepsis patients with myocardial dysfunction were correlated with LVEF,28d survival rate and APACHE Ⅱ score.ROC curve analysis showed that values of plasma BNP levels and Ee'in sepsis patients with myocardial dysfunction were better in predicting the 28 d survival rate,while their combination was the best.Conclusions Plasma BNP levels and Ee'in sepsis patients with myocardial dysfunction are correlated with the severity and prognosis,therefore,provide reference indexes for the assessment of severity and prognosis of patients with sepsis and myocardial dysfunction.