重症肺炎患者肌钙蛋白I测定意义及其对预后的影响

Significance of cardiac troponin I in the patients with severe pneumonia

目的 分析重症肺炎患者心肌肌钙蛋白I（cTnI）的变化,探讨其对预后的影响及意义.方法 观察49例重症肺炎患者于入院后24 h、72 h测定cTnI值,评估cTnI升高率.将患者分为cTnI正常组和cTnI升高组,比较两组患者APACHEⅡ评分、中心静脉血氧饱和度（ScvO2）及死亡率等 另根据预后分为生存组及死亡组,比较两组患者cTnI值变化.结果 49例患者中33例cTnI升高,升高率为67.3% cTnI正常组和cTnI升高组APACHEⅡ评分、ScvO2及死亡率差异均有统计学意义（P＜0.05） 生存组和死亡组24 h、72 h cTnI值差异均有统计学意义（P＜0.05）,死亡组cTnI值呈进行性上升（P＜0.05）.结论 重症肺炎患者cTnI值升高较常见,cTnI监测对判断其预后有一定意义.

Objective To investigate the changes of cardiac troponin I in the patients with severe pneumonia, and to analyze its prognosis. Methods cTnI levels were measured in 49 patients with severe pneumonia at 24 h and 72 h after admission. The elevated rate was calculated. All the patients were allocated into two groups according to their cTnI levels, the elevated group and the normal group. APACHE II score, central venous blood oxygen saturation （ScvO2）and mortality between the groups were compared. According to the prognosis, all the patients were divided into the survival group and the death group. The changes of cTnI levels between the groups were compared. Results cTnI was elevated in 33 of all the patients, elevation rate was 67. 3%. Significant differences were found in APACHE II score, ScvO2 and mortality between the elevated group and the normal group （ P 〈 0.05 ） ; cTnI levels at 24 h and 72 h were significantly different between survival group and death group （ P 〈 0.05）, the cTnI levels in the death group were progressively increased. Conclusion Increased cTnI in the patients with severe pneumonia is common, the changes of cTnI play an important role in evaluating the prognosis of illness.