心力衰竭病史、冠心病病史及乳酸值对脓毒性心肌病的诊断价值分析  

The diagnosis value of history of heart failure,history of coronary heart disease and lactate value on septic cardiomyopathy

作　　者：符会妮[1] 吕树志[2] 余君 FU Hui-Ni(Department of Emergency,the second people's hospital Nanyang,Nanyang,He'nan,473000,China)

机构地区：[1]南阳市第二人民医院急诊科,河南南阳473000 [2]南阳市第二人民医院心血管内科,河南南阳473000

出　　处：《齐齐哈尔医学院学报》2020年第18期2262-2264,共3页Journal of Qiqihar Medical University

摘　　要：目的探究心力衰竭病史、冠心病病史及乳酸值在脓毒性心肌病患者中的诊断价值。方法选择2019年1月—2020年3月本院接受治疗的121例脓毒症或脓毒性休克患者为研究对象,分为脓毒性心肌病组和非脓毒性心肌病组两组。其中,脓毒性心肌病组23例,非脓毒性心肌病组98例。分析两组患者基线资料及预后情况,并使用多元Logistic回归分析判断脓毒性心肌病的相关危险因素。结果脓毒性心肌病在脓毒症或脓毒性休克患者中的发病率约为19.01%(23/121);两组患者在性别、心力衰竭、冠心病相比较,差异有统计学意义(P<0.05);两组患者在C反应蛋白(CRP)、降钙素原(PCT)相比较,差异无统计学意义(P>0.05);两组患者在年龄、APACHEⅡ评分、SOFA评分、ICU住院时间、入ICU时乳酸水平相比较,差异有统计学意义(P<0.05);进一步的回归分析显示,既往心力衰竭病史、冠心病病史和入ICU乳酸水平>4.0 mmol/L是脓毒性心肌病发生的独立危险因素(P<0.05)。结论脓毒症或脓毒性休克患者发生脓毒性心肌病的几率较高,应特别加强对合并心力衰竭病史、冠心病病史以及入ICU时乳酸水平>4.0 mmol/L患者的监护。Objective To investigate the value of heart failure history,coronary heart disease history and lactate value in the diagnosis of patients with septic cardiomyopathy.Methods 121 patients with sepsis or septic shock who were treated in our hospital from January 2019 to March 2020 were selected as the research object,and they were divided into septic cardiomyopathy group and(n=23)and the non-septic cardiomyopathy group(n=98),the baseline data and prognosis of the two groups of patients were analyzed,and multiple logistic regression analysis was used to determine the related risk factors of septic cardiomyopathy.Results The incidence of septic cardiomyopathy in patients with sepsis or septic shock was about 19.01%(23/121).There were statistically significant difference in gender,history of heart failure,history of coronary heart disease between the two groups(P<0.05).There were no significant difference in C-reactive protein(CRP),and procalcitonin(PCT)between the two groups(P>0.05).In aspect of age,APACHE II score,SOFA score,ICU hospital stay,lactate level when admitted to the ICU,there were statistically significant difference(P<0.05).The results of regression indicated that previous history of heart failure,history of coronary heart disease and ICU lactate level over 4.0 mmol/L at admission were independent risk factor for the occurrence of septic cardiomyopathy(P<0.05).Conclusions Patients with sepsis or septic shock have a higher probability of developing septic cardiomyopathy.In particular,monitoring should be strengthened for patients with a history of heart failure,coronary heart disease,and patients entering the ICU with lactate levels over 4.0 mmol/L.

关 键 词：心力衰竭 冠心病 乳酸值 脓毒性心肌病 危险因素 

分 类 号：R541[医药卫生—心血管疾病]