Dissertation > Excellent graduate degree dissertation topics show

Clinical Study of Change of NT-proBNP and Its Significance in Severe Trauma Patients

Author: QianAnZuo
Tutor: XuShaoWen
School: Zhejiang University
Course: Clinical
Keywords: Severe trauma N-terminal B-type natriuretic peptide Sepsis Troponin Blood volume
CLC: R641
Type: Master's thesis
Year: 2010
Downloads: 52
Quote: 1
Read: Download Dissertation

Abstract


Background: Currently, the N-terminal B-type natriuretic peptide (N-terminal pro-B-type natriuretic peptide, NT-proBNP) is mainly used for the differential diagnosis of dyspnea emergency; heart failure and other cardiovascular diseases, diagnosis, prognosis, therapeutic effect evaluation and so on. However, in patients with severe trauma on the application of few studies. Objective: To study the NT-proBNP in patients with severe trauma variation of the possible influencing factors, and the clinical application value. METHODS: A prospective observational study, 50 patients with severe trauma measured emergency intensive care unit stay (Emergency intensive care unit, EICU) 1,3,7 days after NT-proBNP levels, acute physiology and chronic health evaluation (Acute physiology and chronic health evaluation, APACHE) Ⅱ, Glasgow coma score (Glasgow coma score, GCS), myocardial creatine kinase isoenzyme (MBisoenzyme of creatine kinase, CK-MB). troponin - Ⅰ (Cardiac troponin I, cTn -I), procalcitonin (Procalcitonin, PCT); also recorded the first 1,3 days CVP (Central venous pressure, CVP), and the second one day to three days out of the amount of liquid; serious injury were recorded scores (Injury severity score, ISS). Observed 50 cases of severe trauma patients NT-proBNP levels of dynamic changes. Analysis and comparison of different prognostic groups with different degree of injury in patients with NT-proBNP changes in the characteristics and differences of NT-proBNP for prognosis and disease severity value of the correlation analysis survivors NT-proBNP levels and duration of hospitalization (Length Of Stay, LOS), duration of mechanical ventilation correlation. CVP of NT-proBNP and the correlation of their respective correlation values ??change, changes in the value of NT-proBNP is associated with fluid balance. Groups were compared with brain injury and is not accompanied by brain injury group, PCT PCT elevated group and the normal group differences between NT-proBNP. Analysis of NT-proBNP and each time point GCS, CK-MB, cTn-I correlation. And at each time point and NT-proBNP correlated factors stepwise linear regression analysis. Results: 50 cases of severe trauma patients after injury 1,3,7-day average of NT-proBNP levels did not change significantly. Death group at each time point of NT-proBNP were significantly higher than the survival group. Group on the 7th day of death than the first day of NT-proBNP was significantly higher (P lt; 0.05). 7th day survival group compared with NT-proBNP on day 1, the first three days were lower (P lt; 0.05). ISS ≥ 25 group and the ISS lt; 25 group, at each time point NT-proBNP were higher (P lt; 0.05). ISS ≥ 25 group at each time point was no significant statistical difference between, ISS lt; 25 Group of seven days compared with the first three days levels decreased (P lt; 0.05). 32 patients on day 3 and day 1 NT-proBNP difference (△ NT-proBNP) and the first three days with the first one day CVP difference ΔCVP have a good correlation (r = 0.708, p lt; 0.001). With brain injury group and no brain injury group at each time point were no significant differences in NT-proBNP. The first group of 3,7 days PCT elevated NT-proBNP was significantly higher than PCT normal group (P lt; 0.05). Each time point of NT-proBNP and CK-MB, cTn-I have a weak correlation (P lt; 0.05) Conclusion: Severe trauma patients admitted to hospital after high levels of NT-proBNP and NT-proBNP continued to maintain a high level tips poor prognosis. NT-proBNP can be used to determine the prognosis of patients with severe trauma and severity of the disease. Dynamic observation of changes in NT-proBNP levels in patients in combination with other indicators to assess the capacity assessment of the patient's volume status, making the liquid guide clinical management decisions. Severe trauma patients after injury, elevated NT-proBNP levels also may be associated with myocardial injury, sepsis has a certain relationship. Traumatic brain injury patients with NT-proBNP levels with and without brain injury patients showed no significant difference. NT-proBNP testing severe trauma as a valid indicator of disease surveillance.

Related Dissertations

  1. The Effect of Hemoperfustion in Different Time on the Proinflammatory Cytokines and Survival Time of Sepsis Rabbits,R459.7
  2. The risk Beihai academic thinking and clinical experience and the application of gastrointestinal recovery method of therapeutic effects of sepsis, intestinal dysfunction,R249.2
  3. Multi-center Study of Early Hemofiltration Treat Sepsis Associated AKI,R692.5
  4. Clinical Efficacy Observation with Fu-Zheng-Gu-Ben on Septic Acute Deficiency Syndrome Patients,R278
  5. Study on Clinical Value of High-sensitivity Cardiac Troponin T Assay in Myocardial Infarction,R542.22
  6. Septic lung injury (ALI / ARDS) in patients with peripheral immune parameters Th1, Th2, HLA-DR and Treg changes and Integrative Medicine,R459.7
  7. Blood circulation in sepsis induced multiple organ dysfunction syndrome treatment effect,R278
  8. To Explore the Value of Plasma NT-proBNP and Hypersensitive C-reactive Protein in Evaluating the Prognosis of the Patients with Acute Coronary Syndrome,R541.4
  9. The Significance of Triggering Receptor Expressed on Myeloid Cells-1(TREM-1) in Neonatal Rats Septicemia with E.coli,R363
  10. Application Research of a Novel Septic Rat Model Design by Cecal Ligation and Puncture,R-332
  11. The Effect of Tunicamycin Pretreatment on Septic Neonatal Rat Cardiomyocytes Activity and Mitochondrial Function,R459.7
  12. The Effects of Autophagy on Cardiomyocytes Viability and Mitochondrial Membrane Potential in Sepsis,R459.7
  13. Anti- macrophage migration inhibitory factor monoclonal antibody identification and protective mechanisms Sepsis Study,R459.7
  14. The Influence of Omega 3 Polyunsaturated Fatty Acid on the Immune Function of Sepsis,R459.7
  15. Correlation between Coagulation Disorders and Sepsis Severity and Prognosis.,R459.7
  16. Retrospective Study about the Prognostic Value of N-terminal Pro-B-type Natriuretic Peptide and APACHE Ⅱ Score in Elderly Patients of SICU,R459.7
  17. Clinical Significance of the Dynamic Change of T Lymphocyte Subsets in Patients with Sepsis,R459.7
  18. The Influence of Xuebijing Injection and Low Molecular Weight Heparin on Coagulation Function and Prognosis in the Patients with Severe Sepsis,R459.7
  19. Retrospective Study on the Predictive Value of Th1/Th2 Cytokines in Pediatric Hematology-oncology Patients with Sepsis for the Severity and Treatment,R720.597
  20. Analysis on the Myocardial Injury of A/H1N1 Influenza Infection,R511.7
  21. The Analytical Performance Assessment and Clinical Application of High-sensitivity Cardiac Troponin Assays,R446.1

CLC: > Medicine, health > Surgery > Traumatology > Trauma
© 2012 www.DissertationTopic.Net  Mobile