脓毒症患者血清超敏肌钙蛋白水平与其预后的关系  

Relationship between Level of Serum High-sensitive Troponin I and Prognosis in Patients with Sepsis

作　　者：余追[1] 田建国[1] 李光[1] 张迪[1] 严娟娟[1] 周青山[1] 

机构地区：[1]武汉大学人民医院重症医学科,武汉430060

出　　处：《微循环学杂志》2013年第1期57-59,I0002,共4页Chinese Journal of Microcirculation

基　　金：湖北省自然科学基金资助项目(2011CDB479)

摘　　要：目的:探讨血清超敏肌钙蛋白(hs-TnI)水平与脓毒症患者预后的关系。方法:脓毒症患者112例,入院1h内检测hs-TnI水平,并将其分为hs-TnI正常组和hs-TnI升高组;入院24h内进行APACHEⅡ评分。分析hs-TnI升高组hs-TnI水平与APACHEⅡ评分的相关性;比较两组患者基础疾病和并发症急性肾损伤(AKI)分布;比较两组患者升压药、机械通气及针对AKI的连续性肾脏替代治疗(CRRT)的使用率和使用时间;比较两组总住院时间、住ICU时间和住院死亡率、ICU死亡率。结果:hs-TnI升高组基础疾病比例和AKI发生率显著高于hs-TnI正常组(P<0.01)。hs-TnI水平升高患者APACHEⅡ评分也升高,两者呈显著正相关(r2=0.5958,P<0.01)。两组机械通气和升压药使用率无显著性差异(P>0.05),hs-TnI升高组机械通气和升压药治疗时间显著长于hs-TnI正常组(P<0.05或P<0.01),针对AKI的CRRT使用率高于hs-TnI正常组(P<0.05);hs-TnI升高组患者的总住院时间、住ICU时间、住院死亡率和ICU死亡率显著高于hs-TnI正常组(P<0.05)。结论:hs-TnI升高有助于判断脓毒症患者预后,hs-TnI水平越高,预后越差。Objective: To investigate the relationship between level of high-sensitive troponin I (hs-TnI) and prognosis in patients of sepsis. Method: 112 patients of sepsis were collected and divided into normal hs-TnI group and high hs-TnI group according to their serum hs-TnI level within 1 hr after hospitalization. APACHEⅡscores were tested within 24 hours after hospitalization. Correlation between APACHEⅡ and hs-TnI was analyzed in high hs-TnI group, distributions of other illness and AKI, usage of vasopressors, mechanical ventilation(MV), continuous renal replacement therapy (CRRT) aimed at AKI, length of hospitalization and stay in ICU, hospital motality and ICU mortality were compared between the two groups. Results: More complications and high incidence of AKI were observed in high hs-TnI group than in normal hs-TnI level(P<0.01).The level of hs-TnI was correlated positively with APACHEⅡscore in these patients with high serum hs-TnI(r2=0.5958, P<0.01). There was no difference of usage of mechanical ventilation and vasopressors between the two groups(P>0.05), but the time of MV and therapy of vasopressors were longer in high hs-TnI group than in normal hs-TnI level(P<0.05 or P<0.01). Length of hospital stay and ICU stay were both longer in patients of high hs-TnI group compared with those of normal hs-TnI group(P<0.05). Hospital mortality and ICU mortality increased significantly in patients with high level of hs-TnI(P<0.05). Conclusion: Serum hs-TnI may help to evaluate prognosis of patients with sepsis, higher level of serum hs-TnI, worse prognosis.

关 键 词：超敏肌钙蛋白 脓毒症 APACHEⅡ评分 预后 

分 类 号：R446[医药卫生—诊断学]