血cTnI、NT-proBNP水平对脓毒症心肌损伤患者28 d存活率的预测价值  

Predictive value of the detection of serum levels of cTnI and NT-proBNP for 28-day survival rate in patients with sepsis induced myocardial injury

作　　者：于斌[1] 陈华[2] 秦皓[1] 邢冬[1] 苏洁[1] 程子安[1] 白宗江 王澜涛[1] YU Bin;CHEN Hua;QIN Hao(Emergency Department,The Fourth Hospital of Hebei Medical University,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院急诊科,石家庄市050011 [2]河北省人民医院心脏中心

出　　处：《河北医药》2020年第24期3708-3712,共5页Hebei Medical Journal

摘　　要：目的探讨在脓毒症心肌损伤患者28 d存活率的预测中,血心肌肌钙蛋白I(cTnI)、N-末端脑钠肽前体(NT-proBNP)的应用价值。方法选取2019年1月至2020年8月脓毒症心肌损伤患者80例,根据患者28 d存活情况将其分为2组,即存活组、死亡组,每组40例,对比2组血cTnI、NT-proBNP与SOFA评分结果,并行Logistic回归、相关性分析,同时绘制受试者工作特征曲线(ROC)评价预测价值。结果死亡组SOFA评分均高于存活组(P<0.05);从入院当日到入院后14 d,死亡组血cTnI、NT-proBNP、SOFA评分结果均高于存活组(P<0.05);单因素与多因素Cox回归分析,血cTnI、NT-proBNP、SOFA评分是影响脓毒症心肌损伤患者预后的危险因素(P<0.05);相关性分析,血cTnI、NT-proBNP与SOFA评分均表现出正相关性(r=0.740,r=0.691,P<0.001);ROC分析,cTnI、NT-proBNP、SOFA评分的曲线下面积分别为0.736、0.827、0.624。结论血cTnI、NT-proBNP与SOFA评分呈现为密切相关性,在脓毒症心肌损伤患者28d存活率预测中具有较高应用价值。Objective To investigate the application value of the detection of serum levels of cardiac troponin I(cTnI)and N-terminal pro brain natriuretic peptide(NT-proBNP)in predicting the 28-day survival rate of patients with sepsis induced myocardial injury.Methods A total of 80 patients with myocardial injury due to sepsis who were treated in our hospital were enrolled in the study.According to the 28-day survival condition of patients,these patients were divided into survival case group and death case group,with 40 cases in each group.The serum levels of cTnI,NT-proBNP and SOFA scores were observed and compared between the two groups,moreover,the Logistic regression and correlation analysis were performed.Meanwhile,receiver operating characteristic curve(ROC)was drawn to evaluate the predictive value.Results The SOFA scores in death case group were significantly higher than those in survival case group(P<0.05).The serum levels of cTnI,NT-proBNP and SOFA scores from the day of admission to 14 days after admission in death case group were significantly higher than those in survival case group(P<0.05).The single factor and multivariate Cox regression analysis showed that serum levels of cTnI,NT-proBNP and sofa scores were the risk factors affecting the prognosis of patients with myocardial injury due to sepsis(P<0.05).In addition the correlation analysis showed that serum levels of cTnI,NT-proBNP were positively correlated with SOFA scores(P<0.01).The ROC analysis showed that the area under the curve of cTnI,NT-proBNP and sofa scores were 0.736,0.827 and 0.624,respectively.Conclusion The serum levels of cTnI,NT-proBNP are closely related with SOFA scores,which has higher application value in predicting the 28-day survival rate of patients with myocardial injury due to sepsis.

关 键 词：脓毒症心肌损伤 CTNI NT-PROBNP 28d存活率 预测 

分 类 号：R631[医药卫生—外科学]