血清D-二聚体、cTnI联合肌红蛋白在急诊脓毒症临床诊断及病情评估中的应用  

Serum D-Dimer and cTnI Combined with Myoglobin in the Clinical Diagnosis and Condition Assessment of Emergency Sepsis

作　　者：王晓宁[1] 刘畅[1] 孙家安 WANG Xiao-ning;LIU Chang;SUN Jia-an(Department of Emergency,Zhengzhou Central Hospital,Zhengzhou,Henan,450007,China)

机构地区：[1]郑州市中心医院急诊科,河南郑州450007

出　　处：《中国血液流变学杂志》2024年第4期557-561,共5页Chinese Journal of Hemorheology

摘　　要：目的探究D-二聚体(D-dimer,D-D)、肌钙蛋白(cardiac troponin I,cTnI)联合肌红蛋白(myoglobin,Mb)在急诊脓毒症临床诊断及病情评估中的应用价值。方法选取郑州市中心医院急诊科在2021年7月—2024年3月收治的113例脓毒症患者为观察组,另选取同期进行体检的健康人群92名为对照组。对比两组D-D、cTnI、Mb水平,比较观察组不同病情严重程度的D-D、cTnI、Mb水平,绘制ROC曲线,分析血清D-D、cTnI、Mb单独及联合检测脓毒症的诊断效果。结果观察组D-D、cTnI、Mb水平均显著高于对照组(P<0.05);D-D、cTnI、Mb水平由低到高:脓毒症组<严重脓毒症组<脓毒性休克组(P<0.05);D-D、cTnI、Mb三者联合诊断脓毒症的AUC为0.890,敏感度为0.934,特异度为0.902,高于D-D、cTnI、Mb单独检测(P<0.05)。结论血清D-D、cTnI、Mb检测可提高急诊脓毒症患者的早期诊断效能,同时能有效评估病情进展,可为临床治疗提供临床依据。Objective To investigate the value of D-dimer(D-D)and cardiac troponin I(cTnI)combined with myoglobin(Mb)in the clinical diagnosis and assessment of sepsis in emergency medicine.Methods 113 patients with sepsis admitted to the Emergency Department of Zhengzhou Central Hospital from July 2021 to March 2024 were selected as the observation group,and 92 healthy people who underwent medical examination during the same period were selected as the control group.The levels of D-D,cTnI and Mb in the two groups were compared,and the levels of D-D,cTnI and Mb in different severity of disease in the observation group were compared.ROC curves were drawn to analyze the diagnostic effects of serum D-D,cTnI,Mb alone and in combination for detecting sepsis.Results The levels of D-D,cTnI,and Mb in the observation group were significantly higher than those in the control group(P<0.05).The levels of D-D,cTnI and Mb were from low to high:sepsis group<severe sepsis group<septic shock group(P<0.05).The AUC for the combined diagnosis of sepsis with D-D,cTnI,and Mb was 0.890,the sensitivity 0.934,and specificity 0.902,which was higher than that of D-D,cTnI,and Mb alone(P<0.05).Conclusion Detection of serum D-D,cTnI and Mb can improve the early diagnostic efficacy of patients with sepsis in emergency,and can effectively evaluate the disease progression,which can provide clinical evidence for clinical treatment.

关 键 词：D-二聚体 CTNI 肌红蛋白 急诊脓毒症 临床诊断 病情评估 

分 类 号：R459.7[医药卫生—急诊医学]