急性呼吸衰竭患者血清cTnI水平变化及其与心肌损伤的相关性  

Changes of serum cTnI level in patients with acute respiratory failure and its correlation with myocardial injury.

作　　者：雷磊 王倩梅 赵鹏 刘传明 李俊杰 LEI Lei;WANG Qian-mei;ZHAO Peng;LIU Chuan-ming;LI Jun-jie(Department of Emergency Medicine,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,Shaanxi,CHINA)

机构地区：[1]空军军医大学第一附属医院急诊科,陕西西安710032

出　　处：《海南医学》2021年第24期3149-3151,共3页Hainan Medical Journal

摘　　要：目的观察急性呼吸衰竭患者血清心肌肌钙蛋白(cTnI)水平,并分析其与患者心肌损伤的关系。方法选取空军军医大学第一附属医院急诊科收治的180例急性呼吸衰竭患者(观察组),按照是否产生心肌损伤分为心肌损伤组(n=65)与非心肌损伤组(n=115),并取同期60例既往无任何基础疾病的单纯胸痛就诊者为对照组,比较三组受检者的临床资料、血清cTnI与N末端B型钠尿肽原(NT-proBNP)水平,采用Pearson法分析cTnI与NT-proBNP水平相关性,并利用受试者工作特征(ROC)曲线分析血清cTnI水平对急性呼吸衰竭患者心肌损伤的预测价值。结果观察组患者的血清cTnI、NT-proBNP水平分别为(0.31±0.05)ng/mL、(1217.65±198.46)pg/mL,明显高于对照组的(0.06±0.01)ng/mL、(90.24±17.16)pg/mL,差异均有统计学意义(P<0.05);心肌损伤组患者的血清c TnI及NT-proBNP水平分别为(0.34±0.06)ng/mL、(1652.74±305.18)pg/mL,明显高于非心肌损伤组的(0.20±0.03)ng/mL、(756.82±124.57)pg/mL,差异均有统计学意义(P<0.05);血清cTnI与NT-proBNP水平之间呈正相关(P<0.05);ROC曲线显示,血清cTnI预测心肌损伤的曲线下面积为0.844(95%CI:0.777~0.911),随cTnI浓度升高,灵敏度呈现逐渐降低趋势,特异度呈现逐渐增加趋势,血清cTnI为0.30 ng/mL时,灵敏度为71.9%,特异度为88.6%。结论急性呼吸衰竭患者血清cTnI水平呈现明显升高趋势,且合并心肌损伤者升高更明显,可用于心肌损伤的早期评估。Objective To observe the changes of serum cardiac troponin(cTnI)level in patients with acute respiratory failure,and analyze its relationship with myocardial injury.Methods A total of 180 patients with acute respiratory failure(observation group)from the Department of Emergency Medicine at the First Affiliated Hospital of Air Force Medical University were enrolled in this study.According to presence or absence of myocardial injury,the patients were divided into myocardial injury group(n=65)and non-myocardial injury group(n=115).Meanwhile,60 patients without any underlying disease who were treated due to simple chest pain were selected as the control group.The clinical data,serum cTnI,and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels of the three groups of subjects were compared.Pearson correlation analysis of cTnI and NT-proBNP levels was performed.The predictive value of serum c TnI level for myocardial injury in patients with acute respiratory failure was analyzed with the receiver operating characteristic(ROC)curve.Results The levels of serum cTnI and NT-proBNP in the observation group were(0.31±0.05)ng/mL and(1217.65±198.46)pg/m L,significantly higher than(0.06±0.01)ng/m L and(90.24±17.16)pg/m L in the control group(P<0.05).The levels of serum c Tn I and NT-pro BNP in the myocardial injury group were(0.34±0.06)ng/m L,(1652.74±305.18)pg/mL,significantly higher than(0.20±0.03)ng/mL and(756.82±124.57)pg/mL in the non-myocardial injury group(P<0.05).Serum cTnI level was positively correlated with NT-proBNP level(P<0.05).ROC curve analysis showed that the area under the curve of serum cTnI level for predicting myocardial injury was 0.844(95%CI:0.777to 0.911).With the increase of cTnI level,the sensitivity showed a decreasing trend,while the specificity showed an increasing trend.When the serum cTnI level was 0.30 ng/mL,the sensitivity and the specificity were 71.9%and 88.6%,respectively.Conclusion Patients with acute respiratory failure have significantly elevated serum cTnI levels,and the incr

关 键 词：急性呼吸衰竭 心肌肌钙蛋白 N末端B型钠尿肽原 心肌损伤 

分 类 号：R563.8[医药卫生—呼吸系统]