Changes And Clinical Significance Of BNP And Hs-CRP Levels In Patients With Sepsis

Objective: To explore the change and significance of Brain natriuretic peptide(BNP) 、high sensitivity C-reactive protein(hs-CRP) and PCT in patients with sepsis and its correlation with left atrial diameter(LAD)、left ventricle end-diastolic diameter(LVEDD)、left ventricle ejection fraction(LVEF)and fraction shortening(FS). Method:Select the 50 patients with sepsis(sepsis group),40 patients with general infection(general infection group)and the 30 people with healthy subjects(control group) were chosen for the study. The levels of BNP were detected with by Enzyme-linked immunosorbent assay(ELISA); The levels of hs-CRP and PCT were detected with by immune turbidimetry;The parameters of left atrial diameter(LAD),left ventricle end-diastolic diameter(LVEDD),left ventricle ejection fraction(LVEF), fraction shortening(FS)were detected with echocardiography. ROC was constructed to observe the prognostic value of the biomarkers. Result:(1)The plasma BNP 、hs-CRP and PCT in general infection group and sepsis group were significantly higher than the control group in the first day(All P<0.01).but compared with the general infection group, the plasma BNP、hs-CRP and PCT were significantly increased(P<0.01).(2)The LAD and LVEDD in general infection group and sepsis group were significantly higher than the control group in the first day(All P<0.01).but compared with the general infection group, the LAD and LVEDD were significantly increased(P<0.01).the LVEF and FS in general infection group and sepsis group were significantly Lower than the control group in the first day(All P<0.01).but compared with the general infection group, the LVEF and FS were significantly decreased(P<0.01).(3)Correlation analysis revealed a strong correlation between the BNP with hs-CRP and PCT; The levels of BNP 、hs-CRP and PCT were positively correlated with LAD and LVEDD(All P<0.01),and were negatively correlated with LVEF and FS(All P<0.01).(4) The area under the curve(AUC) of BNP 、hs-CRP 、PCT and APACHEII were 0.904、0.847、0.937 and 0.849, respectively. The sensibility and specificity of BNP were 86.3% and 90.16%, the sensibility and specificity of hs-CRP were 80.17% and 82.71%,the sensibility and specificity of PCT were 82.44% and 91.42%,the sensibility and specificity of APACHEII were 87.33% and 95.37%.(5)compared with the 24 h,The plasma BNP 、hs-CRP and PCT in sepsis group were significantly increased in 48 h.compared with the 48 h,The plasma BNP 、hs-CRP and PCT in sepsis group were significantly increased in 120 h.(6)compared with the 24 h,The LAD and LVEDD in sepsis group were significantly increased in 48 h,the LVEF and FS were significantly decreased in 48 h.compared with the 48 h,The LAD and LVEDD in sepsis group were significantly increased in 120 h,the LVEF and FS were significantly decreased in 120 h. Conclusion: The concentration of BNP and hs-CRP were increased in patients with sepsis, which were closely associated with cardiac function. Measuring plasma BNP and hs-CRP levels may be helpful for judging the severity of cardiac function with sepsis.