脓毒血症患者高敏肌钙蛋白T水平及预后判断的价值研究  

The value of high-sensitivity troponin T levels and prognosis in sepsis

作　　者：苗强[1] 李立新[1] 唐江涛[1] 朱帅[1] 王伟青[1] 都向阳[1] 李贵星[1] 

机构地区：[1]四川大学华西医院实验医学科,四川成都610041

出　　处：《中国实验诊断学》2017年第3期438-441,共4页Chinese Journal of Laboratory Diagnosis

基　　金：四川省科技厅支撑计划(2016SZ0044)

摘　　要：目的探讨脓毒血症患者高敏心肌肌钙蛋白T水平及预后判断的价值。方法选取我院2014年1月至2014年12月脓毒血症住院患者156例为研究对象,选取同期健康体检者323例为健康对照,统计患者的年龄、性别、住院天数,检测患者入院时(day0)及第5天(day5)降钙素原(PCT)和高敏心肌肌钙蛋白T(hs-cTnT)水平,健康对照组仅检测纳入时PCT和hs-cTnT水平。研究对象按入院时和第5天PCT的变化分为PCT升高组(29例)和PCT降低组(127例),比较患者年龄、性别及不同时间点hs-cTnT水平和PCT水平。结果脓毒血症患者hs-cTnT水平为28.3(12.9,86.2)ng/L高于健康对照人群3.0(3.0,3.8)ng/L(P<0.05);脓毒血症患者入院时PCT水平为5.24(2.93,19.35)ng/ml,hs-cTnT水平为28.25(12.92,83.55)ng/L,两者相关性为r=0.332(P<0.05),第5天PCT水平为1.34(0.56,4.69)ng/ml,hs-cTnT水平为22.60(11.15,56.35)ng/L,两者相关性为r=0.439(P<0.05);PCT升高组第5天hs-cTnT水平为60.7(26.8,187.4)ng/L,明显高于入院时hs-cTnT水平27.5(11.8,123.4)ng/L(P<0.05),PCT降低组第5天hs-cTnT水平为18.7(8.9,43.2)ng/L低于入院时hs-cTnT水平29.0(13.0,83.4)ng/L(P<0.05);PCT升高组病情恶化率达72.4%,高于PCT降低组34.6%(P<0.05)。结论脓毒血症对心肌细胞产生损伤,脓毒血症严重程度和心肌细胞损伤程度密切相关,hs-cTnT水平对脓毒血症患者的预后具有指导意义。Objective To investigate the levels and changes of high-sensitivity troponin T in patient with sepsis,and its prognosis value.Methods Selecting 156 inpatients with sepsis enrolled in our hospital from January 2014 to December 2014 as subjects and 323 healthy subjects within the same period,we then recorded the patient＇s age,sex,length of stay,detecting the levels of procalcitonin（PCT）and high-sensitivity troponin T（hs-cTnT）of patients on admission day（day0）and the 5th day（day5）respectively and of healthy control group only on including.Patients were divided into PCT elevated group（29cases）and PCT lower group（127cases）according to changes of the measured levels of PCT on the 5th day.Comparing the patient＇s age,sex,the levels of hs-cTnT and PCT at different time points.Results The median level of hs-cTnT in sepsis patients was 28.3（12.9,86.2）ng/L,higher than the 3.0（3.0,3.8）ng/L in healthy control subjects（P〈0.05）,while the median levels of PCT and hs-cTnT were 5.24（2.93,19.35）ng/ml and 28.25（12.92,83.55）ng/L respectively on admission day with the correlation index being r=0.332（P〈0.05）.Accordingly,on the 5th day the median levels of PCT and hs-cTnT were 1.34（0.56,4.69）ng/ml and 22.60（11.15,56.35）ng/L respectively with the correlation index being r=0.439（P〈0.05）.In PCT elevated group the median level of hs-cTnT on the 5th day was 60.7（26.8,187.4）ng/L,significantly higher than the 27.5（11.8,123.4）ng/L on admission day（P〈0.05）,while in PCT lower group the median level of hs-cTnT on the 5th day was 18.7（8.9,43.2）ng/L,lower than the 29.0（13.0,83.4）ng/L on admission day（P〈0.05）.The deterioration rate in PCT elevated group was as high as 72.4percent,significantly higher than 34.6percent in PCT lower group（P〈0.05）.Conclusion As patients with sepsis often suffer from myocardial cells injury,the degrees of myocardial cells injury were closely related to the severity of sepsis.The levels of hs-cTnT were of more significanc

关 键 词：脓毒血症 脓毒症心肌功能障碍 降钙素原 高敏肌钙蛋白T 

分 类 号：R459.7[医药卫生—急诊医学]