老年重度脓毒症合并心肌抑制患者心肌损伤标记物变化及价值

Changes and value of the cardiac injury biomarkers concentration of elderly severe sepsis patients with cardiac depression

目的 探讨老年重度脓毒症合并心肌抑制患者心肌损伤标记物肌钙蛋白 I、T(c Tn I、c Tn T)、肌酸激酶 (CK)、肌酸激酶同工酶 (CK- MB)变化及其判断预后的价值。方法 4 3例老年重度脓毒症患者确诊后次日进行血浆心肌损伤标记物检测 ,连续 3日行心脏超声监测其心功能 ,确定患者是否并发心肌抑制 ,比较两组心肌损伤标记物水平 ,并通过 ROC曲线下面积比较心肌损伤标记物预测心肌抑制及不良预后的价值。结果 并发心肌抑制者的血浆 CK- MB、c Tn I、c Tn T水平明显升高 ,c Tn I、c Tn T预测心肌抑制的价值高于 CK- MB。c Tn I阳性患者死亡率高但无显著性差异。结论 肌钙蛋白检测对预测老年脓毒症患者有无心肌抑制有较高价值 ,对不良预后无明显预测价值。

Objective To study the cardiac inju ry biomarkers concentration of elderly severe sepsis patients with cardiac depression and their value on o utcome prediction.Methods 43 elderly severe sepsis pat ients were included,bl ood samples were taken in next morning of diagnosis for detection of cardiac inj ury biomarkers:CK,CK-MB,cTnT and cTnI.UCG were performed in consecutive 3 days after sepsis diagnosis for identification of cardiac depression.Patients were grouped according cardiac function.Levels of CK,CK-MB,cTnT and cTnI were compared between two groups.And area under ROC were measured and compared to e valuate the value of different biomarkers in predicting cardiac dysfunction and outcome. Results Leve ls of CK-MB,cTnT and cTnI were elevated in patients developing cardiac depres sion,and cardiac troponins were better than CK-MB in predicting cardiac depres sion,cTnI positive patients might have higher mortality,but no statistic dif ferent was found in this study.Conclusion Cardia c troponins are good biomarkers in predicting cardiac dysfunction of severe sepsis,but aren't so good in out come prediction.