脓毒血症患者早期血清心肌肌钙蛋白Ⅰ、肌酸激酶同工酶的变化及临床意义  

Changes and clinical significance of cardiac troponin I and creatine kinase-MB levels in patients with early stage of sepsis

作　　者：赵凯[1] 邱强[2] 程江[3] 

机构地区：[1]新疆维吾尔自治区石河子大学医学院第一附属医院ICU,832008 [2]新疆维吾尔自治区石河子大学医学院第一附属医院心内一科,832008 [3]新疆维吾尔自治区石河子大学医学院第一附属医院检验科,832008

出　　处：《中华灾害救援医学》2015年第4期199-201,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探讨脓毒血症患者血清心肌肌钙蛋白I(cardiac troponin I,c Tn I)、肌酸激酶同工酶(creatine kinase-MB,CK-MB)的变化及其相关因素的临床意义。方法选取新疆石河子大学医学院第一附属医院重症监护病房(intensive care unit,ICU)收治的脓毒血症患者40例(脓毒血症组),一般感染患者40例(一般感染组),同时选取同期健康体检者20例(对照组),采用全自动生化分析仪检测各组实验对象入院早期血清c Tn I、CK-MB、C反应蛋白(C-reactive protein,CRP)水平,超声心动图测量左房舒张期末内径(left atrial diameter,LAD)、左室舒张末期内径(left ventricle end-diastolic diameter,LVEDD)、左室射血分数(left ventricle ejection fraction,LVEF)、短轴缩短率(fraction shortening,FS),同时记录入院时急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluation scoring systemⅡ,APACHEⅡ)评分。结果与对照组比较,一般感染组、脓毒血症组患者血清c Tn I、CK-MB、APACHEⅡ评分、CRP、LAD、LVEDD均显著增高,LVEF、FS均显著降低,差异均有统计学意义(P<0.05);与一般感染组比较,脓毒血症组患者血清c Tn I、CK-MB、APACHEⅡ评分、CRP、LAD、LVEDD均亦显著增高,LVEF、FS均显著降低,差异均有统计学意义(P<0.05)。结论脓毒血症患者血清c Tn I、CK-MB水平均显著升高,并与LAD、LVEDD、LVEF、FS有一定的联系,并值得进一步研究其相关性。检测血清c Tn I、CK-MB水平有助于判断脓毒血症患者病情。Objective To explore on the change and clinical significance of serum cardiac troponin I （cTnI） and creatine ki- nase-MB （CK-MB） levels and its correlation factors in patients with early sepsis. Methods 40 patients with sepsis （sepsis group）, 40 patients with general infection （general infection group）, 20 healthy subjects （control group） were recruited at the ICU department of the first affiliated hospital of Shihezi university. Serum cTnI, CK-MB and C-reactive protein （CRP） levels of subjects were detected with automatic biochemical analyzer just after they were admitted to hospital. The parameters of left atrial diameter （LAD）, left ventri- cle end-diastolic diameter （LVEDD）, left ventricle ejection fraction （LVEF）, fraction shortening （FS） were detected with echocardio- graphy, and acute physiology and chronic health evaluation scoring system 11 （APACHE 11 ） score were recorded as well. Results Compared with the control group, the levels of cTnI, CK-MB, CRP, APACHEII score, LAD and LVEDD in general infection group were significantly increased, LVEF and FS were significantly decreased. And compared with the general infection group, the levels of cTnI, CK-MB, CRP, APACHE]/score, LAD and LVEDD in the sepsis group were significantly increased, LVEF and FS were signifi- cantly decreased , all of the differences were statistically significant （ P 〈 0.05 ）. Condusions The levels of serum cTnI and CK-MB were all increased in patients with sepsis, and they may be linked with LAD, LVEDD, LVEF and FS. Measuring serum level of eTnI and CK-MB may be helpful in judging the severity of sepsis.

关 键 词：脓毒血症 心肌肌钙蛋白Ⅰ 肌酸激酶同工酶 心功能 

分 类 号：R631[医药卫生—外科学]