炎症因子、心功能指标与重症脓毒症患者心功能损伤的相关性分析  

Relationship between cardiac function damage in patients with severe sepsis and inflammatory factors,cardiac function indicators

作　　者：伍伟光 颜建辉 何敏锋 陈小武 林子靖 WU Weiguang;YAN Jianhui;HE Minfeng;CHEN Xiaowu;LIN Zijing(Department of Emergency,Dongguan Binhai Bay Central Hospital,Dongguan,Guangdong 523900,China;Department of Infectious Diseases,Dongguan Binhai Bay Central Hospital,Dongguan,Guangdong 523900,China)

机构地区：[1]东莞市滨海湾中心医院急诊科,广东东莞523900 [2]东莞市滨海湾中心医院感染科,广东东莞523900

出　　处：《检验医学与临床》2025年第7期969-973,977,共6页Laboratory Medicine and Clinic

基　　金：2023年东莞市社会发展科技项目(20231800904482)。

摘　　要：目的探讨炎症因子、心功能指标在重症脓毒症患者血清中的表达水平,以及与心功能损伤的相关性。方法选取2021年1月至2022年11月在该院接受治疗的80例重症脓毒症患者为研究对象,根据患者左心室射血分数(LVEF)分为心功能损伤组和非心功能损伤组。比较2组心肌损伤指标N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTNI)、肌酸激酶同工酶(CKMB)和炎症因子指标C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平,以及序贯器官衰竭(SOFA)评分、急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分;采用Pearson相关分析重症脓毒症患者心功能指标与炎症因子、心肌损伤指标、SOFA及APACHEⅡ评分的相关性。结果心功能损伤组纳入28例患者,非心功能损伤组纳入52例患者。心功能损伤组LVEF、二尖瓣E峰与A峰比值(E/A)明显低于非心功能损伤组,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室短轴缩短率(FS)、室间隔舒张末期厚度(IVS)、SOFA及APACHEⅡ评分明显高于非心功能损伤组,差异均有统计学意义(P<0.05)。心功能损伤组CKMB、cTnI、NT-proBNP水平明显高于非心功能损伤组,心功能损伤组血清CRP、PCT、TNF-α、IL-6水平明显高于非心功能损伤组,差异均有统计学意义(P<0.05)。相关分析结果显示,LVEF与CKMB、cTnI、NT-proBNP、CRP、PCT、TNF-α、IL-6、SOFA评分、APACHEⅡ评分呈显著负相关(P<0.05);E/A与cTnI、NT-proBNP、PCT、TNF-α、SOFA评分、APACHEⅡ评分呈显著负相关(P<0.05);FS与CKMB、cTnI、PCT、TNF-α、IL-6、SOFA评分、APACHEⅡ评分均呈显著正相关(P<0.05);LVEDD、LVESD、IVS与CKMB、cTnI、NT-proBNP、CRP、PCT、TNF-α、IL-6、SOFA评分、APACHEⅡ评分均呈显著正相关(P<0.05)。结论重症脓毒症合并心功能损伤患者炎症因子、心肌损伤指标表达明显升高,且与患者的心功能损伤指标显著相关,为临床上�Objective To explore the expression levels of inflammatory factors and cardiac function indicators in the serum of patients with severe sepsis and their relationship with cardiac function damage.Methods A total of 80 patients with severe sepsis who were treated in Dongguan Binhai Bay Central Hospital from January 2021 to November 2022 were selected according to left ventricular ejection fraction(LVEF),they were grouped into cardiac function injury group and non-cardiac function injury group.The levels of N-terminal pro-brain natriuretic peptide precursor(NT-proBNP),troponin I(cTNI),creatine kinase isoenzyme(CKMB)and inflammatory factors-C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),Sequential Organ Failure Assessment(SOFA)score and Acute Physiological And Chronic Health EvaluationⅡ(APACHEⅡ)score were compared between the two groups.The correlation between cardiac function indexes,inflammatory factors,SOFA,APACHEⅡscores and myocardial injury indexes in patients with severe sepsis was analyzed by Pearson correlation.Results A total of 28 cases in the heart function injury group and 52 cases in the non heart function injury group.LVEF and ratio of mitral E peak to A peak(E/A)in the cardiac function injury group were obviously lower than those in the non-cardiac function injury group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular short axis shortening rate(FS),ventricular septal end-diastolic thickness(IVS),SOFA,APACHEⅡscores in the cardiac function injury group were obviously higher than those in the non-cardiac function injury group,the differences were significant(P<0.05).CKMB,cTnI and NT-proBNP in cardiac function injury group were obviously higher than those in non-cardiac function injury group,the expression levels of CRP,PCT,TNF-αand IL-6 in the cardiac function injury group were obviously higher than those in non-cardiac function injury group(P<0.05).Correlation analysis showed that

关 键 词：炎症因子 心功能指标 重症脓毒症 心功能损伤 相关性分析 

分 类 号：R446.1[医药卫生—诊断学] R631[医药卫生—临床医学]